PATHOGENESIS AND TREATMENT OF HODGKINS-DI SEASE

Although the pathogenesis of Hodgkin's disease is not clear, molecular analyses reveal characteristic features. EBV infection can be demonst rated in more than 50% of cases at the DNA or protein level. Recently, immunoglobulin gene rearrangements were found in single Hodgkin and R eed-Stemberg cells. Sequence analyses revealed that the rearranged Ig genes have frequently somatic mutations, which indicate that the tells are derived from the germinal center. These rearrangements may be use d as defined markers to detect residual disease after chemotherapy. Mo dern polychemotherapy regimen and radiotherapy are very effective, and 60-90% of patients, depending on stage of the disease and risk factor s, can be cured. Salvage therapy for relapsed patients including high- dose chemotherapy with autologous stem cell support frequently results in remission although duration is frequently short. New immunotherapy strategies with immunotoxins or bispecific antibodies are currently a nalysed in clinical studies.