The prognosis for a lymphoma
introduction
The Hodgkin lymphoma is a malignant tumor of the lymphatic system with painless swelling of the lymph nodes. Compared to many other malignant tumors, its prognosis is associated with high cure rates and depends on the spread of the tumor. Significant advances in therapy have been achieved over the past 30 years. Therapeutic measures are adapted to the stages accordingly. In this way, on average, about 80% of all patients with Hodgkin lymphoma can be cured.
If the disease is recognized in its early stages, the cure rate even increases to 90%. Some of the patients cannot be cured despite advanced therapy options. Alternative treatments, such as therapy with targeted antibodies, are currently the subject of research.
Prognosis in early stages 1 and 2 of lymphoma
in the Stage I. of the Ann Arbor Classification, Hodgkin's lymphoma is limited to a single lymph node region. The current therapy guidelines see a Hodgkin lymphoma without risk factors chemotherapy from two cycles with subsequent Irradiation in front.
in the Stage II According to the Ann Arbor classification, Hodgkin's lymphoma has affected at least two or more lymph node regions on one side of the diaphragm. Even with Hodgkin's lymphoma II without risk factors, current guidelines recommend chemotherapy consisting of two cycles and subsequent radiation.
Both stages are further divided into A and B. This depends on the presence of the so-called B symptoms together, i.e. the appearance of fever, Night sweats and Weight loss. The so-called intermediate stages with one or more risk factors, the treatment currently consists of four cycles of chemotherapy with subsequent radiation.
In the early stages of Hodgkin's lymphoma, healing rates are around 90% after a period of five years. The survival rates within the same period are 95%.
Chemotherapy and radiotherapy measures, especially in high doses, are not without side effects. About 15% of patients experience late complications over the course of 10 to 20 years. These include primarily Second neoplasms (Appearance of another tumor) how Breast cancer or Thyroid cancer, but also diseases of the heart. Therapy-related sequelae of this kind play an important role, particularly in the early stages of Hodgkin's lymphoma. As a result of the good healing prospects, the risk of dying from a late complication is comparatively higher. After around 15 years, the annual probability of the occurrence of therapy-related diseases is around 1%.
The criteria for a generally poor prognosis for early Hodgkin lymphoma are a large tumor Mediastinum (tissue space in the chest cavity), more than three affected lymph node areas, one high Sedimentation rate and B-symptoms as well as age over 50.
Prognosis in advanced stages 3 and 4 of lymphoma
In stage III of the Ann Arbor classification, at least two or more lymph node regions are affected by non-Hodgkin lymphoma not just on one but on both sides of the diaphragm.
Read more on the topic: Non-Hodgkin lymphoma
Stage IV of the Ann Arbor classification involves extensive involvement of organs such as the liver and lungs as well as tissue infiltration. Lymph nodes can also be affected.
The usual therapy in the advanced stages is chemotherapy consisting of six cycles. Thereafter, radiation therapy can be used to destroy the remaining malignant (malignant) tissue. The therapy regimen differs depending on age, spread and risk factors.
In the advanced stages, healing rates vary between a little more than 50% and 80% in the first five years after diagnosis, while survival rates are between 80% and 90%. Varying prognosis factors as well as the variety of applied therapy schemes explain the wide range of 5-year survival rates.
Life expectancy in lymphoma
Thanks to sophisticated therapy options, Hodgkin lymphomas can also be cured in more advanced stages. Healing is defined as one relapse-free period of 10 years. About 80% of all patients after therapeutic intervention survive the defined period of time without recurrence.
Almost all relapses of Hodgkin's lymphoma occur within the first five years of first occurring. Most of the relapses can be observed in the first two and a half years.
In a few cases, a relapse cannot be completely ruled out even after 10 or 20 years. In general, however, the chances of recovery increase the longer the time elapses before the disease first occurs.
The average life expectancy compared to the normal population is reduced despite the high chance of recovery. Chemotherapy and radiation therapy particularly damage the heart muscle and the lung and thyroid tissue. Fertility disorders can also be observed more frequently. In about a fifth of the cases, another malignant tumor develops as a late complication within 20 years. Mostly it is breast or thyroid cancer. Also one acute myeloid leukemia can occur as a result of chemotherapy and radiation therapy.
