Department of Pediatrics, Pediatric Hematology/Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
CARTOX Program, Department of Pediatrics, Pediatric Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Int J Mol Sci. 2023 Jun 13;24(12):10095. doi: 10.3390/ijms241210095.
Hodgkin lymphoma, a hematological malignancy of lymphoid origin that typically arises from germinal-center B cells, has an excellent overall prognosis. However, the treatment of patients who relapse or develop resistant disease still poses a substantial clinical and research challenge, even though current risk-adapted and response-based treatment techniques produce overall survival rates of over 95%. The appearance of late malignancies after the successful cure of primary or relapsed disease continues to be a major concern, mostly because of high survival rates. Particularly in pediatric HL patients, the chance of developing secondary leukemia is manifold compared to that in the general pediatric population, and the prognosis for patients with secondary leukemia is much worse than that for patients with other hematological malignancies. Therefore, it is crucial to develop clinically useful biomarkers to stratify patients according to their risk of late malignancies and determine which require intense treatment regimens to maintain the ideal balance between maximizing survival rates and avoiding late consequences. In this article, we review HL's epidemiology, risk factors, staging, molecular and genetic biomarkers, and treatments for children and adults, as well as treatment-related adverse events and the late development of secondary malignancies in patients with the disease.
霍奇金淋巴瘤是一种起源于淋巴样生发中心 B 细胞的血液系统恶性肿瘤,总体预后良好。然而,即使目前采用风险适应和基于反应的治疗技术,总体生存率超过 95%,复发或出现耐药疾病的患者的治疗仍然是一个重大的临床和研究挑战。在原发性或复发性疾病成功治愈后出现晚期恶性肿瘤仍然是一个主要关注点,这主要是因为生存率高。特别是在儿科霍奇金淋巴瘤患者中,与普通儿科人群相比,发生继发性白血病的几率更高,且继发性白血病患者的预后比其他血液系统恶性肿瘤患者差得多。因此,开发临床上有用的生物标志物来根据患者发生晚期恶性肿瘤的风险对其进行分层,并确定哪些患者需要强化治疗方案,以在最大限度提高生存率和避免晚期后果之间达到理想的平衡至关重要。本文综述了霍奇金淋巴瘤在儿童和成人中的流行病学、危险因素、分期、分子和遗传标志物以及治疗方法,以及与治疗相关的不良事件和疾病患者继发性恶性肿瘤的晚期发展。