Advances in the diagnosis and management of lymphoma

dvances in the diagnosis and management of lymphoma Review (2253) Total Article Views Authors: Word ZH, Matasar MJ Published Date February 2012 Volume 2012:2 Pages 29 - 55 DOI: http://dx.doi.org/10.2147/BLCTT.S15554 Received: 16 November 2011 Accepted: 06 December 2011 Published: 09 February 2012 Zachary H Word1, Matthew J Matasar1,2 1Lymphoma Service, Department of Medicine, Memorial Sloan–Kettering Cancer Center, 2Department of Medicine, New York Presbyterian Hospital, New York, NY, USA Abstract: The lymphomas are a heterogeneous group of cancers that have played a prominent role in the history of oncology, being among the first cancers to respond to radiotherapy or systemic chemotherapy. Progressive improvement in the understanding of the biology and natural history of these diseases has led to changes in both classification and management. Because of the heterogeneity present among the lymphomas, accurate diagnosis and staging are essential prerequisites to their effective management. Lymphoma stage frequently informs treatment decisions, but in contrast with solid tumor malignancies carries limited prognostic value. This has led to the development of prognostic models in lymphoma, which use patient and disease characteristics to stratify patients by risk. Modern approaches to Hodgkin's lymphoma include chemotherapy only, combined-modality therapy with both chemotherapy and radiotherapy, and risk-adapted approaches that modify treatment based on initial response. Management of non-Hodgkin's lymphoma (NHL) varies widely depending upon histology. Use of rituximab, the anti-CD20 monoclonal antibody, is included in the management of most B cell lymphomas and has improved outcomes in these diseases. The T cell lymphomas are less common and generally less well understood than the B cell diseases, and their management has only recently become disease-specific. Though effective therapy is available for many types of lymphoma, relapse remains common in a number of subtypes, and management of relapsed and refractory disease remain research priorities.