Book Review

Hodgkin Lymphoma

N Engl J Med 2008; 358:317-318January 17, 2008

Article

Hodgkin Lymphoma
Second edition. Edited by Richard T. Hoppe, Peter T. Mauch, James O. Armitage, Volker Diehl, and Lawrence M. Weiss. 466 pp., illustrated. Philadelphia, Lippincott Williams & Wilkins, 2007. $199. ISBN: 978-0-7817-6422-3

In the second edition of this important book, published 8 years after the first edition, the title has been changed from Hodgkin's Disease to Hodgkin Lymphoma, in accordance with the World Health Organization's system of classification for lymphoma. But this is not the only change. The first edition reflected progress that had been made during the previous 50 years, and this second edition contains an up-to-date discussion of the management of patients with Hodgkin's lymphoma, including all the progress that has been made during the past few years in understanding the pathology of the disease. The chapters on epidemiology and on Epstein–Barr virus have been greatly improved, even though the story of the relationship between Epstein–Barr virus and Hodgkin's lymphoma has not yet been fully told.

The section on biology and pathology is the one that has changed the most from the first edition; it now includes all the tools for genetic analysis that have appeared recently. Some new data on microarray analysis are lacking because all such studies have been published only very recently, but the major improvements are included in the book. Two chapters are devoted to the immune response and its abnormalities in the pathogenesis of the disease. The chapters in section III, which focus on staging, discuss the new imaging tools — particularly positron-emission tomography scanning. Section IV, “Treatment Principles and Techniques,” covers new directions in cancer treatment, including monoclonal antibodies and immunotherapy.

Section V covers all the possibilities for the treatment of localized, disseminated, or recurring disease, but the inclusion of some opinions from the authors on how to treat a new patient who is not a participant in a clinical trial, as well as summary charts and pictorial algorithms, would have improved these chapters. Not all patients reach a complete remission with the first treatment, and these patients present the most difficult problem for oncologists who treat patients with Hodgkin's lymphoma. A chapter on the treatment of these patients would have been useful, even though bits of the topic are covered in other chapters.

Hodgkin's lymphoma is a cancer that can and should be cured in most patients. For this reason, the late effects of treatment are particularly important, and the chapters in section VI address these effects in detail, including the implications of the choice of the initial treatment and possible techniques for the prevention of late effects. This book contains nearly everything a practical oncologist needs to know about Hodgkin's lymphoma.

Hodgkin's lymphoma is not the only cancer we can cure now, but it was certainly the first one that had an increasing cure rate in parallel with progress in radiation therapy, then in chemotherapy, and now in immunotherapy. Although the therapeutic methods are not changing as quickly in Hodgkin's lymphoma as they are in non-Hodgkin's lymphoma or in multiple myeloma, improvements in treatment regularly arise from new discoveries about the pathology of the disease and new therapeutic agents. It is thus difficult to maintain an up-to-date book on the subject, but this one succeeds in most sections.

Overall, this book summarizes our understanding of Hodgkin's lymphoma. It is useful for oncologists or for anyone who cares for patients with the disease. The publisher has also made a searchable version of the book available on the Internet for anyone who purchases a hard copy, and this is certainly a useful tool.

Bertrand Coiffier, M.D., Ph.D.
Hospices Civils de Lyon, 69310 Pierre Bénite, France
bertrand.coiffier@chu-lyon.fr