Hodgkin’s Disease is a group of cancers of the lymph nodes. The cancer is rare, but very important since it is curable in most cases. Many patients first notice their disease when to feel a swollen lymph node or develop fevers, night sweats or weight loss.

Treatment of Hodgkin’s Disease varies according to the stage of disease at diagnosis. Patients with disease limited to one area may be curable (in up to 70-80%) with radiation with or without chemotherapy. Patients with disease that has spread may still be curable (in up to 60%) with chemotherapy.

If the Hodgkins Disease fails to respond to initial treatment or recurs following treatment, consideration of high-dose transplantation therapy becomes appropriate. This is especially true if the disease returns within 12 months of initial treatment. A British National Lymphoma Trial compared transplantation at relapse with standard dose chemotherapy. More patients receiving transplantation remained in remission at 3-years compared to those patients receiving standard treatment (53% versus 10%). (Linch DC et al: Lancet 1993: 341) A French trial also suggested superiority to transplantation when one adverse prognostic factor was present (Gajewski JL et al: J Oncol 1996: 14:572)

The Adult Stem Cell- Bone Marrow Transplant Program of Hackensack University Medical Center has active transplant treatment protocols for Hodgkin’s Disease. . For more information on this treatment or to schedule an appointment call (201) 996-5849.

AUTOLOGOUS TRANSPLANT OPTIONS

High-dose treatments with BCNU, etoposide, cytarabine, and cyclophosphamide (BVAC) rescued by autologous peripheral blood stem cells can be curative in patients with relapsed or refractory Hodgkin’s Disease. Patients with marrow involvement by disease may also benefit from tumor purging of the autologous peripheral blood stem cells in our stem cell laboratory. We are currently offering patients "positive" selection techniques using a CD34 column. For more information on our stem cell selection methods, check out the stem cell laboratory section.

ALLOGENEIC TRANSPLANT OPTIONS

For patients with Tissue-matched (HLA-matched) brother/sister bone marrow donors allogeneic transplantation treatment protocols may be appropriate. One trial uses high-dose cyclophosphamide combined with either total body irradiation or high-dose busulfan. Following this aggressive conditioning therapy, bone marrow (or peripheral blood stem cells) from an HLA-matched donor is infused. Graft-versus-host disease prevention is accomplished with combinations of tacrolimus and methotrexate. This very aggressive curative treatment requires a one-month hospitalization.

UNRELATED TRANSPLANT TREATMENT OPTIONS

For patients lacking a family member marrow donor, the Hackensack University Medical Center Transplant Programs are participating in several unrelated transplant protocols.

The National Marrow Donor Program has enlisted over 3 million volunteer bone marrow donors. If an HLA matched unrelated donor can be located, a transplant using high-dose cyclophosphamide and total body irradi

ation can be performed.

Hackensack University Medical Center is also participating in a multicenter trial evaluating the use of expanded Cord Blood Cells in the treatment of cancers and blood diseases. This trial also extends the treatment options for patients without HLA Matched relative donors. For more information click here and also review ex-vivo expansion in the stem cell laboratory section.

NON-TRANSPLANT OPTIONS

In addition to the above transplantation trials, the physicians of the Northern New Jersey Cancer Center have expertise in the diagnosis and treatment of these diseases. Other research studies include a trial of radiotherapy versus chemotherapy versus combined chemotherapy-radiotherapy in early stage disease.

Call (201) 996-5800 for more information on these trials.