Hodgkin lymphoma is a type of lymphoma cancer of lymphocytes. Hodgkin lymphoma differs from non-Hodgkin lymphoma because it has a specific kind of abnormal lymphocyte called a Reed-Sternberg cell.
Hodgkin lymphoma is also known as Hodgkin's disease, although it is more accurate to refer to as Hodgkin lymphoma.
Hodgkin lymphoma is a very treatable and highly curable type of lymphoma with standard therapies such as chemotherapy and radiation therapy. Because Hodgkin lymphoma affects a younger population, our hematologist-oncologists also work closely with Penn Fertility Care to work with patients to preserve their fertility.
What is Hodgkin Lymphoma?
Hodgkin lymphoma is a cancer of lymphocytes, which are white blood cells that circulate throughout the blood and bone marrow. White blood cells are responsible for controlling a person's immune system and fighting off infections.
Lymphocytes are commonly found within the main part of the body's "drainage" system called lymph nodes, as well as in other kinds of body tissue. Therefore, many people diagnosed with lymphoma will have the disease in more than one area of the body.
Hodgkin lymphoma differs from non-Hodgkin lymphoma because it has a specific kind of abnormal lymphocyte called a Reed-Sternberg cell. However, Reed-Sternberg cells make up only a small part of a Hodgkin lymphoma tumor, and the rest of the tumor is made of normal lymphocytes, which can cause inflammation.
If your doctor suspects you have Hodgkin lymphoma, he or she will recommend a surgical biopsy rather than a needle biopsy to make a diagnosis. This is because the characteristic Reed-Sternberg cells may be missed within a smaller tissue sample.
There are approximately 7,800 new cases of Hodgkin lymphoma diagnosed in the United States each year.
Symptoms of Hodgkin Lymphoma
The most common sign of Hodgkin lymphoma is enlarged lymph nodes. However, swollen lymph nodes are not specific to Hodgkin lymphoma. Swollen lymph nodes can occur in other kinds of lymphoma, other cancers or inflammatory diseases with infections. Other signs and symptoms of Hodgkin lymphoma include:
- Night sweats
- Unexplained weight loss
- Fever
- Chills
- Low energy level
- Cough or shortness of breath
Types of Hodgkin's Disease
There are two main types of Hodgkin lymphoma:
Classical Hodgkin Lymphoma
Classical Hodgkin lymphoma accounts for approximately 95 percent of all Hodgkin lymphoma. While different sub-types of classical Hodgkin lymphoma exist, treatment for classical Hodgkin lymphoma is usually the same for all sub-types and is based on the stage of disease.
Nodular Lymphocyte-Predominant Hodgkin Lymphoma
Nodular lymphocyte-predominant Hodgkin lymphoma accounts for about five percent of all Hodgkin lymphoma. People diagnosed with nodular lymphocyte predominant Hodgkin lymphoma can go into a remission with treatment although this disease tends to grow back over time. Sometimes people with this disease do not need to undergo treatment, even when the disease is present.
What Are the Risk Factors of Hodgkin Lymphoma?
Though the cause of Hodgkin lymphoma is not completely clear, there may be some risk factors that increase a person's risk of developing Hodgkin lymphoma.
Risk factors include:
- Age: Hodgkin lymphoma most commonly affects people aged 20 to 30, and older adults.
- Immunosuppressed people: People who have other diseases of the immune system or take drugs that lower the immune system may be at an increased risk.
- Viruses: Both human immunodeficiency virus (HIV) and Epstein-Barr virus (which causes infectious mononucleosis or "mono") may play a role in the development of the disease, though it is not clear why.
How Is Hodgkin's Disease Diagnosed?
Hodgkin lymphoma is diagnosed by review of a lymph node biopsy by pathologists experienced in lymphoma diagnosis. Their analysis will include the shape of the lymphoma cells, immunohistochemistry (expression of protein on the lymphoma cells) and sometimes cytogenetics (DNA changes in lymphoma cells). We require a confirmation by a pathologist of Hodgkin lymphoma before the patient can be seen by a physician.
Tools and Tests
The following tests and diagnostic procedures may be used to diagnose Hodgkin lymphoma:
- A physical exam and full medical history evaluation
- A complete blood count (CBC) that will examine the number of red blood cells and platelets, and the number and type of white blood cells. The CBC will also examine other portions of the blood.
- Blood chemistry studies
- A lymph node biopsy, which will remove part, or the entire lymph node
- Imaging studies such as PET scans, CT scans, chest X-rays and MRI studies
Staging
Hodgkin lymphoma has four different stages as classified by the Modified Ann Arbor Staging System:
- Stage I. Single lymph node region or organ involved with disease.
- Stage II. Two or more lymph node regions involved on the same side of the diaphragm (the muscle that controls breathing and that separates the chest from the abdomen).
- Stage III. Lymph node regions involved on both sides of the diaphragm.
- Stage IV. Significant involvement of an organ that is not considered part of the lymphatic system (like the lung or liver) or any organ involvement along with lymph node involvement.
- Additional designations:
- "B": Unexplained fevers, chills, drenching night sweats, weight loss or fatigue
- "E": Non-lymph node disease that fits into a single area of radiation therapy
- "X": Bulky (large) mass, frequently in the mediastinum (chest)
Typically, stage I or II Hodgkin lymphoma is considered "early" stage and stage III or IV is considered "advanced" stage. Within early stage, patients with low-risk features are considered "favorable" and patients not meeting criteria for low-risk disease are considered "unfavorable".
Is Hodgkin's Lymphoma Curable?
Hodgkin lymphoma is very curable with standard therapies such as chemotherapy and radiation therapy. Because Hodgkin lymphoma affects a younger population, our hematologist-oncologists and other lymphoma treatment specialists also work closely with Penn Fertility Care to work with patients to preserve their fertility.
Below are treatments for Hodgkin Lymphoma:
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