JLE

Bulletin du Cancer

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Cured from Hodgkin's disease Volume 89, issue 7, Juillet - Août 2002

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HDJ d'hématologie, Hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris Cedex 10.

Hodgkin's disease can be cured from 80 to 90% of cases with a regular improvement of therapeutic results since 1960. We detailed the remission criteria with a focus on posttherapeutic residual masses which did not influence the relapse rate. The follow-up of patients in remission is made as an outbasis care every 4 months during the first year than every 6 months with a routine bilan for 10 years. Some adverse events can occur with first, the acute leukemia arising before 10 years, this risk is decreasing with the disminished use of MOPP chemotherapy. The other solid tumors occur later and are related to the patient age, the type of treatment given and individual factors. Thyroid diseases are frequent but mostly benign needing only consumption of thyroid extracts. Fertility is directly related to chemotherapy (including alkylating agents) and to pelvic radiation therapy. With the current use of ABVD-type chemotherapy the preservation of fertility is good but there is a risk for long term cardiopulmonary toxicity almost for the older patients receiving together mediastinal radiation therapy. At the end most long-term survivors of Hodgkin's disease recover a normal socioprofessional life, while reporting a longer duration of fatigue and many children were born after treatments.