What Is Hodgkin Lymphoma?
Non-Hodgkin lymphoma (NHL) is slightly different and occurs when white blood cells called T lymphocytes (T cells) grow out of control.
What Are Symptoms of Hodgkin Lymphoma?
Symptoms of Hodgkin lymphoma include:
- Lump(s) under the skin
- “B symptoms” (usually indicate the lymphoma is more advanced)
- General (non-specific) symptoms
What Causes Hodgkin Lymphoma?
The cause of Hodgkin lymphoma is unknown.
Risk factors for developing Hodgkin lymphoma include:
- Epstein-Barr virus infection/mononucleosis (“mono”)
- Age: most common in early adulthood (especially in a person’s 20s) and in late adulthood (after age 55)
- Gender: occurs slightly more often in males than in females.
- Family history
- Weakened immune system, such as in people infected with human immunodeficiency virus, people who take medicines to suppress the immune system after an organ transplant, and people with auto-immune diseases
How Is Hodgkin Lymphoma Diagnosed?
Hodgkin lymphoma is diagnosed with a physical examination, patient history, and tests such as:
- Imaging tests
- Chest X-ray
- Computed tomography (CT) scan
- CT-guided needle biopsy
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scan
- PET/CT scan
- Bone scan
- Blood tests
- Used to determine how advanced the HL is and how well a patient might tolerate certain treatment
- Tests of heart and lung function
- Echocardiogram (an ultrasound of the heart)
- Multiple-gated acquisition (MUGA) scan to check the heart
- Lung (pulmonary) function tests (PFTs)
What Is the Treatment for Hodgkin Lymphoma?
Treatments for Hodgkin lymphoma may include one or more of the following:
- Along with radiation therapy, chemotherapy is one of the main treatments for Hodgkin lymphoma
- Usually given in combinations
- ABVD is the most common regimen used in the U.S.
- Other common regimens include:
- Radiation therapy
- Along with chemotherapy, radiation therapy is one of the main treatments for Hodgkin lymphoma
- Radiation is given after chemo in the Stanford V regimen and sometimes after the ABVD or BEACOPP regimens
- External beam radiation
- Involved site radiation therapy (ISRT)
- Involved field radiation therapy (IFRT)
- Extended field radiation (rarely done today)
- Total body irradiation: often used along with high-dose chemotherapy in patients getting a stem cell transplant
- High-dose chemotherapy and stem cell transplant
- Autologous stem cell transplant
- Most common type of transplant for Hodgkin lymphoma
- Uses a patient’s own blood stem cells
- Allogeneic stem cell transplant
- Uses blood stem cells from someone else, usually a brother or sister, but could be an unrelated donor or umbilical cord blood
- Autologous stem cell transplant
What Is the Staging for Hodgkin Lymphoma?
The Lugano classification is used to determine the different stages of Hodgkin lymphoma.
For limited stage (I or II) Hodgkin lymphoma that affects an organ outside of the lymph system, the letter E is added to the stage (for example, stage IE or IIE).
- Stage I
- Stage II
- Cancer is found in 2 or more lymph node areas on the same side of (above or below) the diaphragm, which is the thin muscle beneath the lungs that separates the chest and abdomen (II) or
- Cancer extends locally from one lymph node area into a nearby organ (IIE)
- Stage III
- Cancer is found in lymph node areas on both sides of (above and below) the diaphragm (III) or
- Cancer is found in lymph nodes above the diaphragm and in the spleen
- Stage IV
- Cancer has spread (metastasized) widely into at least one organ outside of the lymph system, such as the liver, bone marrow, or lungs
Each stage may also be assigned a letter (A or B). B is added (stage IIIB, for example) if a patient has “B symptoms,” including:
- Loss of more than 10% of body weight over the previous 6 months (without dieting)
- Unexplained fever of at least 100.4°F (38°C)
- Drenching night sweats
B symptoms usually indicate the lymphoma is more advanced, and more intensive treatment is typically recommended.