Paraneoplastic Syndromes in Hodgkin’s Lymphoma

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Congratulations for the excellent review work. 

It is a very extensive review of all the literature currently available. 

I would just like to make a few extra comments:

- In the introductory part you do not comment on the lymphocyte-predominant histology, which has nothing to do with the classic variant and where Reed-Stemberg cells are not present. Perhaps it would be interesting to comment them since the associated paraneoplastic syndromes profile is different.

- I would shorten the part of neurological involvement since it is covered in too much detail to be a review, although it is the most frequent.

On the other hand, the second most frequent, renal involvement, is not sufficiently represented. 

The rest of the work, from my point of view, is very interesting and well balanced. 

Author Response

Please see the attachment. Thank you! 

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

This is a very nice review of the myriad of paraneoplastic syndromes that can be seen with HL.  Please see my comments below:

1.    Paraneoplastic syndromes can occur years before to years after HL diagnosis or relapse. This is stated within in the manuscript, but consider stating it more clearly earlier on in the introduction.  Also add data about percentage of PNS that were diagnosed before, during and after diagnosis with HL.

2. Consider adding a table wiht the high, intermediate and low risk onconeural antibodies

3. On line 140 it says "Since there was no recurrence detected, teh patient made a complete recovery." This sentence should be modified, if the patient made a complete recovery from it is not necessarily because no recurrence was detected.

4. The section on  Rhomboencephalomyelitis does not add much to the discussion since it is so rare with only one case report cited. this section could be removed and added to the table 3 instead.

5. Stiff person’s syndrome is reported with HL. Consider adding a section about this.

5. Table 2 doesn't add a lot of useful information to the manuscript since it is a long list of treatments about a relatively uncommon occurrence.  Why did the authors highlight this diagnosis rather than one of the other ones such as the neurologic ones?

6. CNS PNS is the most common presentation in HL – and is responsible for around ¼ of paraneoplastic syndromes.  Authors should make this more clear in the manuscript.

Author Response

Please see the attachment. Thank you! 

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Congratulations for an excelent work. Everything that we suggested is fixed 

Comments on the Quality of English Language

No comments 

Reviewer 2 Report

Comments and Suggestions for Authors

I appreciate the edits made by the authors.  No further comments.