Hodgkin’s lymphoma, also called Hodgkin’s disease, is a type of lymphoma. Lymphoma is a group of blood cancers that start in the lymphatic system. This system consists of a network of organs, nodes, and vessels throughout your body.
Under normal circumstances, your lymphatic system helps your immune system get rid of waste and fight infections. White blood cells within the lymphatic system, called lymphocytes, help protect you from germs and infections.
Hodgkin’s lymphoma originates in these lymphocytes. More specifically, it tends to develop into a type of cell called B lymphocytes, which produce proteins called antibodies that latch on to foreign invaders and tell your immune system to destroy them.
In people with Hodgkin’s lymphoma, these lymphocytes grow abnormally and crowd out healthy white blood cells. As the disease progresses, it becomes more difficult for your body to fight infections.
Keep reading to learn more about Hodgkin’s lymphoma, including the different types, symptoms, causes, and potential treatment options.
Your lymphatic system covers most of your body and consists of lymph nodes, lymph vessels, and various organs. Here’s an overview of these structures:
- Lymphatic fluid. Also known as lymph, this fluid consists of the extra fluid that drains from your cells, blood vessels, and tissues, as well as other substances such as fats, protein, damaged cells, minerals, viruses, bacteria, and other germs. Your lymphatic fluid is also used to transport lymphocytes. There are two main types of lymphocytes: B lymphocytes (B cells) and T lymphocytes (T cells). These lymphocytes work together to fight infections.
- Lymph nodes. These bean-shaped structures contain white blood cells and other immune cells. You have hundreds of lymph nodes throughout your body, particularly in your abdomen, chest, and groin and under your arms.
- Lymph vessels. Your lymph vessels are a series of vein-like structures that connect your lymph nodes. They help transport lymph and infection-fighting lymphocytes throughout your body.
- Spleen. Situated on the left side of your body, near your stomach, your spleen stores blood cells, filters out damaged cells, and helps maintain the right fluid balance. It also produces lymphocytes.
- Tonsils and adenoids. Your tonsils are collections of lymph tissue in your throat that help protect you from foreign invaders. Adenoids are lumps of lymph tissue near your nasal passage.
- Thymus. Your thymus is an organ in your chest that plays an important role in the development of T lymphocytes.
- Bone marrow. Bone marrow is the spongy tissue inside your bones where blood cells are produced.
- Peyer’s patches. Found in the mucous membrane that lines your small intestine, these small masses of lymphatic tissue help destroy bacteria in your intestines.
According to the
In the late stages, it can reach your bloodstream and spread to other organs, such as your bone marrow, lungs, or liver.
The presence of Reed-Sternberg cells, large cells that may contain more than one nucleus, is the defining feature of Hodgkin’s lymphoma as compared to non-Hodgkin’s.
Hodgkin’s lymphoma is further divided into classic Hodgkin’s lymphoma and nodular lymphocytic predominant Hodgkin’s lymphoma (NLPHL).
The classification depends on the types of cells involved and their behavior. Healthcare professionals can identify the type of Hodgkin’s lymphoma by looking at a sample of the enlarged lymph tissue under a microscope.
Classic Hodgkin’s lymphoma
This type of lymphoma is broken down further into four main subtypes:
- Nodular sclerosis Hodgkin’s lymphoma. This type tends to occur in lymph nodes in the chest or neck. Although anyone can get it, it tends to be more prevalent in teens and young adults. It accounts for about 70 percent of classic Hodgkin’s lymphoma cases.
- Mixed cellularity Hodgkin’s lymphoma. This is the second most common type of classic Hodgkin’s lymphoma. It tends to be most prevalent in people with HIV and typically develops in the lymph nodes of the upper body.
- Lymphocyte-rich classic Hodgkin’s lymphoma. This type is rarer, making up about 5 percent of classic Hodgkin’s lymphoma cases. It’s typically diagnosed at an early stage and is more common in men than in women.
- Lymphocyte-depleted Hodgkin’s lymphoma. This is the rarest type and is most often found in the lymph nodes in the belly, spleen, liver, and bone marrow. It occurs mainly in older adults and people with HIV. It’s typically diagnosed at a more advanced stage.
Nodular lymphocytic predominant Hodgkin’s lymphoma (NLPHL)
This type of Hodgkin’s lymphoma tends to grow more slowly and is rarer than the classic type. It makes up about 5 percent of Hodgkin’s lymphoma cases and affects males about
Abnormal cells in this type are called popcorn cells — they’re large and look like popcorn under a microscope. They’re variants of the Reed-Sternberg cells seen in classic Hodgkin’s lymphoma.
NLPHL may be treated differently than classic Hodgkin’s lymphoma.
The most common symptom of Hodgkin’s lymphoma is swelling of your lymph nodes, which can cause a lump to form under your skin. This lump usually isn’t painful. It often develops in one of the following areas:
- on the side of your neck
- in your armpit
- around your groin
Other symptoms of Hodgkin’s lymphoma include:
- night sweats
- itchy skin
- unintended weight loss
- persistent cough
- trouble breathing
- chest pain
- pain in the lymph nodes after consuming alcohol
- enlarged spleen
Contact a healthcare professional right away if you have any of these symptoms. These can also be symptoms of other health conditions, and it’s important to get an accurate diagnosis.
The exact cause of Hodgkin’s lymphoma
Some factors thought to contribute to the development of classic Hodgkin’s lymphoma include:
It’s thought that genetics may also play a role in the development of NLPHL due to
Known risk factors for Hodgkin’s lymphoma include:
- Age. Most people who develop Hodgkin’s lymphoma are between ages
20 and 40or over 55.
- Epstein-Barr virus. Having been infected with the virus that causes mononucleosis, also called mono, is thought to increase your risk of developing Hodgkin’s lymphoma.
- Being male. The risk is higher for males than for females. In children, about
85 percentof cases occur in boys.
- Family history. People with siblings who have Hodgkin’s lymphoma are at higher risk of developing it, too, and identical twins have a
very high risk. However, most people with Hodgkin’s lymphoma don’t have a family history of it.
- Weakened immune system. People who have HIV are at a higher risk of developing Hodgkin’s lymphoma. People who take immunosuppressant medications after receiving organ transplants are also at an elevated risk.
To diagnose Hodgkin’s lymphoma, your doctor will perform a physical exam and ask you about your medical history. Your doctor will also order certain tests to help them make an accurate diagnosis.
The following tests may be part of the diagnosis process:
- Imaging tests. Imaging tests such as X-rays, PET scans, or CT scans can help your doctor see inside your body to look for enlarged lymph nodes and help determine the stage of the disease.
- Lymph node biopsy. A biopsy involves removing a piece of lymph node tissue to test for the presence of abnormal cells.
- Blood tests. Your doctor may order blood tests such as a complete blood count or an erythrocyte sedimentation rate test to measure levels of red blood cells, white blood cells, and platelets. These tests may also help your doctor understand how advanced the cancer is and how well you’ll respond to treatments. Your doctor may also order blood tests that measure the levels of lactic acid dehydrogenase and uric acid in your blood.
- Immunophenotyping. Doctors will use lab tests to analyze biopsy samples to determine whether lymphoma cells are present and what type they are.
- Lung and heart function tests. Lung function tests and an ultrasound of your heart called an echocardiogram can help determine how well your lungs and heart are working
- Bone marrow biopsy. A bone marrow biopsy involves the removal and examination of marrow inside your bones to see if the cancer has spread.
Once a Hodgkin’s lymphoma diagnosis has been made, the cancer is assigned a stage. Staging describes the extent and severity of the disease. It will also help your doctor determine your treatment options and outlook.
There are four general stages of Hodgkin’s lymphoma:
- Stage 1 (early stage). The cancer is found in one lymph node region, or the cancer is found in only one area of a single organ.
- Stage 2 (locally advanced disease). The cancer is found in two lymph node regions on one side of the diaphragm, which is the muscle beneath your lung, or the cancer is found in one lymph node region and a nearby organ.
- Stage 3 (advanced disease). The cancer is found in lymph node regions both above and below your diaphragm, or the cancer is found in one lymph node area and one organ on opposite sides of your diaphragm.
- Stage 4 (widespread disease). The cancer is found outside the lymph nodes and has spread widely to other parts of your body, such as your bone marrow, liver, or lungs.
Stages are also often assigned either the letter A or B. For example, stage 3A or stage 3B.
According to the
- unintentional weight loss of more than 10 percent of your body weight over the last 6 months
- an unexplained fever higher than 100.4°F (38°C)
- night sweats that drench your sheets
If you don’t have any of the above symptoms, your stage is given the letter A.
Treatment for Hodgkin’s lymphoma typically depends on the stage of the disease. The main treatment options are chemotherapy and radiation.
After treatment, your doctor will want to follow up with you on a regular basis. Be sure to keep all your medical appointments and to carefully follow all your doctor’s instructions.
Radiation therapy uses high energy beams of radiation to destroy cancer cells in specific areas of the body. Radiation therapy generally does well at killing cancer cells in people with Hodgkin’s lymphoma. It’s sometimes administered:
- after chemotherapy for classic Hodgkin’s lymphoma
- by itself in some cases of NLPHL, which tends to spread more slowly than classic Hodgkin’s lymphoma
Doctors tend to use radiation at the lowest effective dose to minimize potential side effects.
Chemotherapy involves the use of medications that can kill cancer cells. Chemotherapy drugs may be taken by mouth or injected through a vein, depending on the specific medication.
- adriamycin (doxorubicin)
- Dacarbazine (DTIC)
Other drug therapies
Along with chemotherapy, various other drug therapies may be used, such as:
- Steroids. Steroids are sometimes added to chemotherapy if initial treatment hasn’t worked or if the cancer is advanced.
- Targeted therapy. Targeted therapy drugs attack cancer cells without damaging healthy cells as much as chemotherapy drugs. A drug in this class called rituximab may be added to chemotherapy if you have NLPHL.
- Immunotherapy. Immunotherapy drugs increase your immune system’s ability to target and destroy cancer cells.
- Brentuximab vedotin. Brentuximab vedotin is a new drug that’s used to treat a specific type of Hodgkin’s lymphoma called CD30-positive Hodgkin’s lymphoma.
Bone marrow transplant
A bone marrow transplant, also called a stem cell transplant, may be an option if you don’t respond well to chemotherapy or radiation. A stem cell transplant infuses healthy cells, called stem cells, into your body to replace the cancerous cells in your bone marrow.
The two main types of bone transplants are:
- Autologous stem cell transplant. Your own stem cells are collected before treatment and stored until after you receive high-dose chemotherapy or radiation. The bone marrow cells are then put back into your body after treatment.
- Allogeneic stem cell transplant. Stem cells from a donor, who’s usually a close relative, are transplanted into your body. Allogeneic stem cell transplants are usually performed only when an autologous transplant has failed.
A number of alternative therapies may help you manage your lymphoma symptoms, although they won’t cure your disease. They can be included along with traditional treatment but shouldn’t be a replacement for it.
Treatment options include:
Clinical trials investigate potential new treatments for Hodgkin’s lymphoma. If these treatments are found to be more effective than the current standard treatments, they become the new standard treatments.
According to the Leukemia & Lymphoma Society, clinical trials are currently exploring:
- monoclonal antibodies
- programmed death checkpoint inhibitors
- CAR T-cell therapy
- the role of interim positron emission tomography/computed tomography
You can ask your doctor about clinical trials in your area that you may be eligible for. You can also find clinical trials through the
Treatments for Hodgkin’s lymphoma can have long-term side effects and can increase your risk of developing other serious medical conditions. Hodgkin’s lymphoma treatments may increase your risk of:
You should get regular mammograms and heart disease screenings, keep up with vaccinations, and avoid smoking.
It’s also important to attend regular follow-up appointments with your doctor. Make sure to tell them about any concerns you may have about long-term side effects and ask what you can do to help reduce potential side effects.
Getting a cancer diagnosis or watching one of your loved ones go through cancer treatment can be incredibly difficult. Support groups and counseling can provide a safe place for you to discuss your concerns and feelings about your experience.
Many resources are available to provide support, advice, and guidance.
Advances in the treatment of Hodgkin’s lymphoma over the past few decades have greatly increased the survival rate. It’s now considered one of the most curable cancers. According to the
The following are the
- Stage 1 Hodgkin’s lymphoma is about 91 percent.
- Stage 2 Hodgkin’s lymphoma is about 94 percent.
- Stage 3 Hodgkin’s lymphoma is about 81 percent.
- Stage 4 Hodgkin’s lymphoma is about 65 percent.
These rates may vary depending on the stage of the disease, your overall health, your age, and how well your cancer responds to treatment.
Hodgkin’s lymphoma is a type of blood cancer that typically develops in your lymph nodes. It causes the abnormal development of a type of white blood cell called lymphocytes. Abnormal development of these cells causes them to replicate uncontrollably and crowd out healthy white blood cells.
The most common early symptom of Hodgkin’s lymphoma is swollen lymph nodes, often around your neck, armpit, or groin.
If caught early, Hodgkin’s lymphoma tends to have a good outlook. It’s important to make an appointment with a healthcare professional if you have any symptoms that could be an indication of lymphoma. The earlier this disease is caught, the higher the chances of a good outcome.