Erkrankungs- und therapiebedingte Spätfolgen beim Hodgkin-Lymphom

Abstract

BackgroundGiven the impressive long-term remission rates in recent years, current clinical research focuses on late sequelae beyond diagnosis and treatment of Hodgkin lymphoma (HL).ObjectivesFollowing treatment of HL, early recognition and treatment of late sequelae is important. Comprehensive care should also be offered to recovering patients in the follow-up phase.ResultsIn the long term, the general overall quality of life of HL patients and survivors is lower than in controls of the same age. The development of cancer-related fatigue (CRF), which can persist long after primary treatment, prevents long-term survivors from continuing their previous lives and returning to work. Other complications include the development of second malignant neoplasms (SMN), which represent a significant mortality risk for former patients. Organ toxicities include cardiac, pulmonary, and gonadal damage. The latter are particularly relevant for young survivors who have not yet completed family planning. Before initiating therapy, the patients should be informed about the possibility of fertility-preserving measures.ConclusionIn view of persistent impairment of quality of life and the negative impact of CRF on the employment of former HL patients, models for targeted care during therapy and in the aftercare phase should urgently be further developed. Recent clinical trials in HL aim at balancing efficacy against acute and chronic sequelae.