Hodgkin lymphoma (HL) is seen in patients over the age of 60 in 20–40% of cases. Prognosis is poorer, largely due to suboptimal staging and treatment in some patients due to concurrent disease. If possible, older patients should be treated along the same principles as younger patients. HL in the pregnant patient should be treated on an individual basis; in the first trimester the pregnancy may have to be terminated, but in most cases in the second and third trimester the judicious use of chemotherapy and radiotherapy may in most cases allow a successful outcome for both patient and child. HL in patients with HIV infection is seen mostly in moderately immune compromised patients. The HL is usually disseminated and prognosis is poorer than in non-HIV patients, although with modern anti-retroviral therapy more patients tolerate treatment and prognosis has improved significantly. Extranodal involvement is relatively rare in HL, although it may be found more frequently with modern imaging techniques. Treatment is as for nodal disease, and prognosis is in general not influenced by extranodal involvement when other factors are taken into account.
9783540784555, 9783540789444, 9783540789554
Radiotherapy for Hodgkin Lymphoma, 2011, p. 167-182