Evidence-based management of Hodgkin's disease: the role of autologous stem cell transplantation.

Hodgkin’s disease is the most common malignancy in individuals in the 10to 30-year-old age group. This malignancy develops in approximately 20,000 individuals in the United States and Canada each year, accounting for an incidence of approximately 3 per 100,000.1,2 The disease is notable in that the malignant cells, the Hodgkin’s-Reed Sternberg (H-RS) cells, constitute less than 5% of the tumor mass; the majority of the mass is comprised of T and B cells as well as a variety of other inflammatory cells such as eosinophils, macrophages, histiocytes, plasma cells, neutrophils, stromal cells, and fibroblasts.2 The histologic subtype of Hodgkin’s disease depends on the reactive cellular environment in which the H-RS cells are found. Classic Hodgkin’s disease is categorized as nodular sclerosis, mixed cellularity, lymphocyte depletion, and a provisional subtype called lymphocyte rich (formerly the diffuse lymphocyte predominance subtype).1,2 The disease is typically unifocal in origin, arises in lymph nodes, and spreads to contiguous nodal groups.2