From the Guidelines
Hodgkin lymphoma is staged using the Ann Arbor staging system, which consists of four main stages: I, II, III, and IV, with additional classifications of A or B for symptom presence or absence, as outlined in the 2017 NCCN clinical practice guidelines 1. The stages of Hodgkin lymphoma are defined as follows:
- Stage I: Involvement of a single lymph node region or localized involvement of a single extralymphatic organ or site.
- Stage II: Involvement of two or more lymph node regions on the same side of the diaphragm, or localized involvement of a single associated extralymphatic organ or site and its regional lymph node(s).
- Stage III: Involvement of lymph node regions on both sides of the diaphragm, which may also be accompanied by localized involvement of an associated extralymphatic organ or site, by involvement of the spleen, or by both.
- Stage IV: Disseminated involvement of one or more extralymphatic organs, with or without associated lymph node involvement, or isolated extralymphatic organ involvement with distant nodal involvement. Each stage is further classified as A (no systemic symptoms present) or B (unexplained fevers, drenching night sweats, or weight loss >10% of body weight within 6 months prior to diagnosis), as described in the study 1. It is essential to note that accurate staging is crucial for determining appropriate treatment strategies and prognosis, with earlier stages generally having better outcomes and potentially requiring less intensive therapy than advanced stages, as supported by the guidelines 1.
From the Research
Stages of Hodgkin's Lymphoma
The stages of Hodgkin's Lymphoma are not explicitly outlined in the provided studies. However, the studies discuss the importance of accurate assessment of the stage of disease in patients with HL for the selection of appropriate therapy 2, 3, 4, 5, 6.
Treatment Based on Stage
The treatment for Hodgkin's Lymphoma varies based on the stage of the disease.
- Patients with early-stage disease are typically treated with combined modality strategies utilizing abbreviated courses of combination chemotherapy followed by involved-field radiation therapy 2, 3, 4, 5.
- Patients with advanced-stage disease receive a longer course of chemotherapy, often without radiation therapy 2, 3, 4, 5, 6.
- The use of positron emission tomography (PET) scan is crucial in determining the response to therapy and adjusting the treatment intensity 2, 3, 4, 6.
Prognostic Models
Prognostic models are used to identify patients at low or high risk for recurrence, and to optimize therapy 2, 3, 4.