How are the cure rates in Hodgkin lymphoma?
Of all malignant diseases, Hodgkin lymphoma belongs to the ones with the best chances for a complete recovery. Nowadays, 80-90% Hodgkin lymphoma patients can be cured by adequate therapy. Patients with early stage Hodgkin lymphoma even have a better prognosis.
How is Hodgkin lymphoma usually treated?
Hodgkin lymphoma is usually treated with a combination of chemotherapy and radiotherapy. The intensity of therapy depends on the stage of disease at the time of diagnosis. In many cases, treatment can be conducted on an outpatient basis.
What are the side-effects of therapy?
Both chemotherapy and radiotherapy can cause adverse effects. Acute adverse effects include nausea and vomiting, an increased susceptibility to infections, fatigue, inflammations of the mucous membranes and others. Certain chemotherapeutic drugs may cause acute or retarded symptoms like prickling or burning sensations, mostly in the feet and hands. In most cases, these symptoms disappear once the respective drug is no longer administered. However, if any of these symptoms occur, you should see your doctor immediately to decide whether your treatment with the respective drug should be discontinued. Further late effects of Hodgkin lymphoma therapy may be heart and lung changes as well as hormonal changes and secondary tumors. Another problem is temporary or permanent infertility, which may be caused by Hodgkin lymphoma therapy.
Fatigue is a permanent subjective feeling of psychic, emotional and/or mental exhaustion that can be observed in many patients already before the start of their treatment. Please speak to your oncologist for further advice or contact the German Fatigue Society (Deutsche Fatigue Gesellschaft).
What is aplasia?
By definition, aplasia is a reduction of the white blood cell count (neutrophil granulocytes below 500/µl, leukocytes below 1000/µl). If the white blood cell count falls below these values, the risk to contract an infection due to a weakened immune system increases. For this reason, patients who are treated on an outpatient basis should avoid crowds of people during aplasia and a physician or a hospital should be consulted immediately if any signs of infection, particularly fever, appear. However, aplasia does not necessarily impair a patient’s general condition.
When do I need blood transfusions?
Both the disease and the therapy cause a decline of the hemoglobin (Hb) value. If the Hb value falls below a certain limit, symptoms like fatigue, weakness, tachycardia (increased heart rate), headache and shortness of breath may occur. The minimum Hb value below which symptoms set in varies from patient to patient. Therefore, the necessity of blood transfusions does not depend on a predefined Hb value, but on the presence of symptoms caused by the low Hb (normal values: > 13.5 g/dl in men, > 12 g/dl in women).
Can I have children after successful chemo- and radiotherapy?
Hodgkin lymphoma therapy may lead to permanent infertility in both men and women. For this reason, male patients are advised to consider a cryopreservation of sperm (preservation of sperm cells by means of liquid nitrogen freezing). In women there is some evidence that taking oral contraceptives (the “Pill”) as well as GnRH analogues during therapy has a fertility-maintaining effect. Besides, the withdrawal and cryopreservation of oocytes or ovary tissue are preserving methods that should be taken into consideration.
What if I become pregnant after therapy?
So far, there is no evidence that there is an increased risk for abnormal embryonic development in children of former Hodgkin lymphoma patients who were successfully cured by chemo- and radiotherapy. Therefore, women are not discouraged from getting pregnant after therapy.
Are there any problems concerning vaccinations?
There are generally two different types of vaccinations: active and passive vaccinations. Passive vaccinations contain antibodies and are administered by means of injection into a vein (intravenously). The patient is protected against the respective disease until the antibodies are depleted.
Active vaccinations contain live or non-live vaccines. The latter contain dead disease agents that still have the agent-specific surface structures which activate the immune system to produce antibodies directed against these agents.
In live vaccines the disease agents are attenuated (weakened) but still able to reproduce themselves. Usually they do not cause any signs of disease in healthy people. By activating the immune system to produce antibodies, live and non-live vaccinations protect the patient against the respective disease for several years or even all life long.
However, live vaccines may cause problems in patients with a weakened immune system because of the living disease agents’ ability to reproduce themselves, which means that they may cause the disease the patient should actually be protected against by the vaccination because the patient’s immune system is not able to control the reproduction of the attenuated agents.
For this reason, patients with a weakened immune system due to disease or therapy should not receive live vaccines (only passive or non-live vaccines). Live vaccines should not be used until the patient’s immune system has recovered after therapy and the blood count is back within the normal range.