Hodgkin Lymphoma

Hodgkin lymphoma, also known as Hodgkin disease, is a type of cancer that affects lymphatic tissue; specifically it develops as a result of the multiplication of mutated B white blood cells (lymphocytes) found in the lymph nodes. These mutated B white blood cells are known as Reed-Sternberg cells. Healthy B white blood cells play an important role in enabling the lymphatic system to protect the body against infections and rid the body of germs, and the presence of Reed-Sternberg cells interrupts these normal processes. Hodgkin disease can occur in both children and adults. However, it is most common in early adulthood (people in their 20s or 30s) and in people over 551.

Credit: National Cancer Institute

What different types of Hodgkin Lymphoma exist?

Hodgkin disease types are classified by the appearance of the abnormal cells under the microscope. This is important because types of Hodgkin disease may grow and spread differently and may be treated differently. There are two main subtypes of Hodgkin lymphoma: classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. About 95 percent of patients have the classical subtype.

To learn more about the different types of Hodgkin disease, visit: http://www.lls.org/#/diseaseinformation/lymphoma/hodgkinlymphoma/hlubtypes/

What are the symptoms of Hodgkin Lymphoma?

Painless swelling of 1 or more lymph nodes near the neck is a characteristic symptom of Hodgkin lymphoma. It is important to keep in mind that Hodgkin lymphoma tends to share non-specific symptoms with other illnesses, and in its earliest stages, Hodgkin lymphoma typically does not have symptoms.

Other symptoms of Hodgkin’s lymphoma include:

  • Swollen lymph nodes in the neck, underarms or groin area
  • Fevers or chills
  • Night sweats
  • Tiredness or no energy
  • Weight loss
  • Itchy skin
  • Abdominal pain or swelling
  • Coughing, shortness of breath, chest discomfort
  • Enlarged spleen

How is Hodgkin Lymphoma diagnosed?

Physical Exams for Hodgkin’s lymphoma will focus on the lymph nodes and other areas typically affected by the disease, including the spleen and liver.

Biopsy is the removal of a portion of or the entire suspicious lymph node. The cells of the removed lymph node are studied under a microscope to confirm a diagnosis and determine the type of Hodgkin lymphoma.

Blood tests for Hodgkin’s lymphoma include complete blood counts (CBCs), blood chemistry tests, protein level tests, liver function tests, kidney function tests, and uric acid level measurements.

Imaging tests use x-rays, magnets, sound waves, or radioactive substances to create pictures of the inside of the body. Imaging tests for Hodgkin’s lymphoma may include computed tomography (CT) scans, positron emissions testing (PET) scans and magnetic resonance imaging (MRI) scans. These imaging tests may show enlarged lymph nodes or tumor masses that occur outside of the lymph nodes, in neighboring areas such as lung, bone or other body tissue.

What are the stages of Hodgkin Lymphoma?

Hodgkin lymphoma is staged according to the Cotswold system (also known as the Modified Ann Arbor Staging System), which uses four stages labeled I, II, III and IV. This system also divides the stages into categories.

Stage I - Involvement of a single lymph node region or a single organ, such as bone.
Stage II - Involvement of two or more lymph node regions that are close to each other
Stage III - Involvement of several lymph node regions in the neck, chest and abdomen (on both sides of the diaphragm).
Stage IV - Widespread involvement of lymph nodes on both sides of the diaphragm and in other organs, such as the lungs, liver and bones.

Categories A, B, X and E.
-The A category indicates the absence of fever, exaggerated sweating and weight loss.
-The B category indicates that patients have fever, excessive sweating and weight loss.
-The X category indicates bulky disease (large masses of lymphocytes).
-The E category indicates organs involved outside of the lymphatic system.

What are the treatment options for Hodgkin Lymphoma?

This Hodgkin lymphoma treatment information does not outline the particular treatment(s) a patient will receive. Rather, it provides general information about the typical treatments used for this type of cancer.

Treatment options:

  • Chemotherapy is the use of drugs to kill cancer cells. For Hodgkin lymphoma, chemotherapy treatments combine several drugs to kill cancer cells in different ways. For this type of cancer, chemotherapy is typically delivered in conjunction with radiation therapy.
  • Radiation Therapy uses high-energy rays or particles to kill cancer cells. It is most effective when Hodgkin lymphoma is located in a single part of the body. It is typically delivered in conjunction with chemotherapy. Types of radiation therapies for Hodgkin’s lymphoma include: involved field radiation, extended field radiation, and total body irradiation.
  • Immunotherapy is the injection of drugs directly into the blood that stimulate the immune system to attack and destroy cancer cells.
  • Stem Cell Transplants rebuild the supply of healthy blood cells in the body and strengthen the immune system. This treatment is used when other treatments have not been effective. Both autologous and allogeneic stem cell transplantation may be used in the treatment of Hodgkin lymphoma.

What are the risk factors of Hodgkin Lymphoma?

  • Age: The disease is most common in early adulthood, between ages 15 to 40 and late adulthood, after age 55.
  • Gender: Males develop Hodgkin lymphoma more often than females.
  • Geography: Hodgkin lymphoma is most common in the United States, Canada and northern Europe and least common in Asian countries.
  • Family History: Siblings of people with the disease are at higher risk. An identical twin of a person with Hodgkin lymphoma is at very high risk. Five percent of Hodgkin Lymphoma cases are linked to a family history of the disease.
  • HIV/AIDS: A person is at higher risk if they are infected with the HIV/AIDS virus.
  • Virus Exposure: Being exposed to the Epstein-Barr virus (EBV), sometimes called mono, slightly raises the risk of developing Hodgkin lymphoma and other lymphomas. 
Mikayla D. Williams , BS student, Nursing , The University of Arizona
Michael Principe, MA, Information Resources and Library Science , The University of Arizona
Works Cited: 
American Cancer Society (2014). Hodgkin Disease. http://www.cancer.org/cancer/hodgkindisease/detailedguide/index
Works Consulted: 
American Society of Clinical Oncology (2014). Lymhoma-Hodgkin. http://www.cancer.net/cancer-types/lymphoma-hodgkin
Leukemia & Lymphoma Society (2014). Lymphoma. http://www.lls.org/#/diseaseinformation/lymphoma/
Cancer Treatment Centers of America (2014). Hodgkin Lymphoma. http://ww2.cancercenter.com/hodgkin-lymphoma/