What is Hodgkin’s Lymphoma?

Lymphoma is a cancer of the lymph system, which consists of lymph nodes, lymphatic vessels, and organs such as the spleen. The lymphatic system is a part of the body’s immune system. There are two main types of lymphoma - Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Data from the National Comprehensive Cancer Network, American Cancer Society, Lymphoma Research Foundation, and other institutions indicates that Hodgkin lymphoma affects approximately 2.6 people out of 100,000 and constitutes around 11% of all lymphomas. Please continue reading to learn more about this condition (previously called Hodgkin’s disease).

What is the most common cause of Hodgkin lymphoma?

Researchers are unsure what exactly triggers Hodgkin lymphoma (previously called Hodgkin disease). We know that it affects a type of blood cell called the white blood cell. Hodgkin’s lymphoma develops when white blood cells called lymphocytes, which the body needs to fight infection, undergo mutations (changes) in their DNA. The affected lymphocytes lose the ability to stop growing. In other words, the mutations cause the blood cells (lymphocytes or lymphoma cells) to multiply uncontrolled. The lymphoma cells also attract normal lymphocytes and other immune cells to support them. They form clusters of cancer cells in the lymphoid tissue and crowd into the lymph nodes, causing swollen lymph nodes and other signs and symptoms of Hodgkin lymphoma.

What are the different types of Hodgkin lymphoma?

There are many different types of Hodgkin lymphoma based on the type of abnormal cells and their behavior. Treatment and prognosis for Hodgkin lymphoma depends on the type.

Classical Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells in the lymph tissue. Doctors further classify it into four subtypes - lymphocyte-rich Hodgkin lymphoma, lymphocyte-depleted Hodgkin lymphoma, mixed cellularity Hodgkin lymphoma, and nodular sclerosis Hodgkin lymphoma.

The other type of Hodgkin’s, besides the classical type, is the nodular lymphocyte-predominant Hodgkin lymphoma. This is a relatively uncommon cancer. The lymphoma cells in this blood cancer are also called popcorn cells because they resemble popcorn kernels in appearance. This type of Hodgkin’s is usually diagnosed in the early stages and is comparatively easier to treat than the classical type.

Note: A lymphoma is classified as Hodgkin's if Reed-Sternberg cells are seen and non-Hodgkin lymphoma if Reed-Sternberg cells are absent.

Who is at risk of developing Hodgkin lymphoma?

Risk factors for Hodgkin lymphoma include:

Age: Hodgkin’s typically affects young adults in their 20s and 30s and people over the age of 55.
Gender: People assigned male at birth have a slightly higher risk of Hodgkin’s than people assigned female at birth.
Family history: A history of Hodgkin lymphoma in a first-degree relative is associated with an increased risk of developing Hodgkin lymphoma.
Epstein-Barr virus: People who have had an infection with a common virus called the Epstein-Barr virus (EBV) (it causes infections such as infectious mononucleosis) are at an increased risk of Hodgkin’s.
HIV infection: People infected with HIV have a weakened immune system and are at an increased risk of developing Hodgkin lymphoma.

Is Hodgkin's lymphoma a serious cancer?

Hodgkin lymphoma is a relatively aggressive cancer of the lymphatic system that can spread rapidly throughout the body. However, it is also an easily treated cancer.

What are the symptoms of Hodgkin’s lymphoma?

The most common symptom of Hodgkin lymphoma is a painless swelling of the affected lymph node tissue in the neck, armpits, and groin. Other symptoms include fever, fatigue, recurrent drenching night sweats, unexplained weight loss, pain in the lymph nodes after consuming alcohol, and itchy skin after bathing or drinking alcohol.

What are the tests for diagnosing Hodgkin lymphoma?

Doctors diagnose Hodgkin lymphoma by performing a physical examination and ordering blood tests and imaging tests. A definitive diagnosis can be made with a lymph node biopsy (this is a minor surgical procedure in which they remove a lymph node and examine it in the laboratory for signs of cancerous cells). A bone marrow biopsy may also be recommended to look for lymphoma cells. Other tests can be done to find markers on the surface of the cancer cells, which can tell doctors what type of Hodgkin’s it is and the best treatments based on the Hodgkin lymphoma subtype.

How do doctors treat Hodgkin lymphoma?

The cancer treatment plan for Hodgkin lymphoma depends on the patient’s general health status, age, type of Hodgkin lymphoma, stage of disease, and other factors. The goal is to kill cancer cells and bring the disease into remission. Treatments for Hodgkin lymphoma may include one or more of the following:

Chemotherapy (the use of drugs to kill cancer cells - this is usually the initial treatment and may be the only treatment in some patients).
Radiation therapy (the use of high-energy beams to kill cancerous cells).
Targeted therapy (the use of drugs to target certain weaknesses in cancerous cells).
Immunotherapy (to help the body’s immune system identify and fight abnormal cells).
Bone marrow transplant or stem cell transplantation for treatment-resistant Hodgkin lymphoma or if Hodgkin lymphoma returns.

What is the life expectancy of a person with Hodgkin's lymphoma?

The 5-year relative survival rate for people with localized Hodgkin lymphoma is 93%. If the cancer has spread to different parts of the body, the 5-year relative survival rate is 83%.

According to the National Cancer Institute, an individual’s life expectancy after a diagnosis of Hodgkin lymphoma can vary depending on various factors such as the stage of the disease, the number of lymph nodes involved, the presence of systemic B symptoms (fever, night sweats, weight loss), age, sex, general health status, and other factors such as an individual’s response to treatment for Hodgkin lymphoma.

Advances in diagnosis and treatment allow many people to make a full recovery from Hodgkin’s lymphoma. The prognosis continues to improve for people with this type of cancer.

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