Current treatment of Hodgkin's disease

In spite of the fact that Hodgkin's disease (HD) remains still an enigma it s management and treatment yield a cure rate of about 80% of all patients. However, this management has two limits: on one side favourable cases which should not be overtreated because of unacceptable side-effects, and on the other side very unfavourable cases which should be treated differently bec ause of a very high rate of failure and/or relapse. Then it becomes necessa ry to precise as thoroughly as possible these two limits in order to choose the adequate treatment for the patient. Prognostic factors based on patien t and disease characteristics allow a relatively exact classification of fa vourable and unfavourable cases. This distinction in two prognostic groups has therapeutic implications in terms of chemotherapy (regimen, duration) a nd radiotherapy (extension, doses). Other specific situations have to be co nsidered, e.g. pediatric cases, pregnancy, old age and HIV-infected patient s who need an adapted management according to very different situations. (C ) 2000 Elsevier Science Ireland Ltd. All rights reserved.