Recurrent Hodgkin's Lymphoma: Prognosis and Symptoms

Advances in the treatment of Hodgkin's lymphoma have resulted in remarkable survival rates, even for diagnoses with advanced unfavorable disease. But for a small percentage of patients, inductive therapy is not enough.

When a patient with Hodgkin's lymphoma has a relapse following induction therapy, he or she is said to have recurrent Hodgkin's lymphoma.

It currently remains unclear why induction therapy fails some patients but works for so many others. Researchers continue to look for biomarkers that may give a clue as to which patients will do well on frontline therapy and which ones will not.

Prognosis

Prognoses for patients with recurrent Hodgkin's lymphoma differ depending on a number of factors. To quote at length from the National Cancer Institute:

Patients who experience a relapse after initial wide-field, high-dose radiation therapy have a good prognosis. Combination chemotherapy results in 10-year disease-free survival (DFS) and overall survival (OS) rates of 57% to 81% and 57% to 89%, respectively. For patients who experience a relapse after initial combination chemotherapy, prognosis is determined more by the duration of the first remission than by the specific induction or salvage combination chemotherapy regimen. Patients whose initial remission after chemotherapy was longer than 1 year (late relapse) have long-term survival with salvage chemotherapy of 22% to 71%. Patients whose initial remission after chemotherapy was shorter than 1 year (early relapse) do much worse and have long-term survival of 11% to 46%.

It is estimated that about 10 percent of Hodgkin's patients will not respond to induction chemotherapy. These patients face high-dose chemotherapy and a stem cell transplant and have less than a 10 percent survival rate eight years following diagnosis.

Symptoms of Recurrent Disease

Some of the symptoms of recurrent Hodgkin's will look and feel very much like the symptoms from a patient's original diagnosis. They include:

• Night sweats
• Lymphadenopathy (swollen lymph nodes)
• Breathing problems
• Bone aches and pains
• Lymphoma itching (without a visible rash present)

Following treatment of Hodgkin's lymphoma, all patients need to be aware of the need for follow-up care and should work to develop a survivorship care plan with their physician.

Sources: National Cancer Institute, Leukemia & Lymphoma Society
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