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The Mystery of the Bimodal Epidemic: Why is Hodgkin's Lymphoma Most Common in Younger and Older People?
Hodgkin's lymphoma (HL) is a lymphoid tumor caused by specific white blood cells - lymphocytes - and is characterized by the presence of multinucleated Reed-Sternberg cells in the patient's lymph nodes. The disease is named after the British physician Thomas Hodgkin, who first described it in 1832. Symptoms of this cancer include fever, night sweats, and weight loss, and patients often find swollen lymph nodes in the neck, armpits, or groin that are not painful. Statistically, the two most common types of Hodgkin lymphoma are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma.
Epidemiological characteristics
Hodgkin lymphoma shows a bimodal incidence curve, which is most common in two age groups: the first peak is in young adults aged 15 to 35 years old, and the second peak is in the elderly over 55 years old. This differs from other lymphomas, where new cases typically rise with age. This phenomenon has attracted widespread attention and research, and is one of the fundamental reasons why Hodgkin lymphoma has reached a high incidence rate among young and old people.
In the United States, the five-year survival rate for Hodgkin lymphoma is 88%, and the survival rate for patients under the age of 20 is as high as 97%.
Diagnosis and Treatment
Diagnosis of Hodgkin lymphoma relies on lymph node biopsy and confirmation of the presence of Reed-Sternberg cells. Treatment options usually include chemotherapy, radiation therapy and stem cell transplantation. Depending on the progression of the cancer and whether it has favorable characteristics, appropriate treatments are selected. If detected early, cure is usually possible. However, patients who receive radiation therapy and certain chemotherapy drugs may be at higher risk for other cancers, heart disease, or lung disease in the future.
Currently, the prognosis for younger patients with Hodgkin lymphoma is much better than that of older patients, as treatments and survival rates for Hodgkin lymphoma continue to improve.
Symptoms and testing
Common symptoms of Hodgkin lymphoma include painless swollen lymph nodes, night sweats, and persistent low-grade fever. In addition to basic lymph node swelling, some patients may also experience brain fatigue, skin itching, etc. Testing will include a lymph node biopsy and whole-body imaging tests such as a CT or PET scan to determine the extent of the cancer.
The connection between young people and old people
Research suggests that the reason why younger and older adults dominate the prevalence of Hodgkin lymphoma may be related to changes in the immune system. Adolescents and young adults have more active immune systems due to increased growth hormone, making them potentially susceptible to abnormal responses after infection, which can lead to lymphoma, while older adults may be more susceptible to viruses due to the progressive decline of their immune systems Such as the impact of Epstein-Barr virus (EBV).
This makes people think, can future research reveal more about the underlying mechanism of this bimodal phenomenon?
Future research directions
Currently, research on Hodgkin lymphoma has begun a new direction, focusing on how to reduce side effects during treatment and long-term effects after treatment. At the same time, researchers are also showing high interest in the application of immunotherapy and targeted therapy in this disease. This will help improve the treatment effect and survival rate of patients of different ages with Hodgkin lymphoma.
Conclusion
The epidemic of Hodgkin lymphoma has fostered in-depth thinking about immunology and virology in the scientific community. If there can be significant progress in the diagnosis and treatment of patients of different ages in the future, it will change the fate of many people. Faced with the increasing number of cases of Hodgkin's lymphoma, we can't help but ask, how will the treatment and management of this disease be changed in the future to achieve better outcomes?
