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Hodgkin's lymphoma: Prognosis and treatment

Tuesday, July 20, 2010; HE06

Hodgkin's lymphoma is a cancer of the immune system. About 8,000 cases a year are diagnosed in the United States, and about 1,300 deaths a year are attributed to the disease.

John Glick, an oncologist at the University of Pennsylvania Hospital, diagnosed my cancer as stage IV-B mixed cellularity Hodgkin's lymphoma. He explained that the stage indicates how widely the disease has spread. The fourth stage is the stage at which it has spread the most, where it exists above and below the diaphragm, and where it has spread to organs outside the lymphatic system. In my case, it had also spread to my bone marrow.

The "B" denotes that the patient has certain symptoms: in my case, fevers and night sweats. Joint pains are not a common symptom of lymphoma; Glick said mine may have been caused by cancer-related pressure in my bone marrow. The pain subsided about four months into chemotherapy and has not returned.

One of the first things Glick told me was that the eight months between my discovery of the lump and his diagnosis would not affect how well I responded to treatment. The urgency with which my family doctor sent me to him was probably just a reflection of his concern for my well-being and desire that I take my condition seriously.

After six months of chemotherapy at Penn, I went into full remission. I stayed in remission for about a year before I relapsed in November 2008. I was then treated at Johns Hopkins in a clinical trial that involved treatments of Rituxan, injections of a special cancer vaccine called KGEL, and more chemotherapy, which included high-dose treatments of Cytoxan.

I went into remission in February 2009 and have not relapsed. Glick says that "patients diagnosed with stage IV-B Hodgkin's lymphoma have a 50 percent chance of cure," defined as remaining in remission for five years.

-- Keith Collins

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