Approximately 173,000 people in the United States are living with Hodgkin lymphoma, or are in remission. Less common than non-Hodgkin lymphoma, Hodgkin lymphoma (sometimes referred to as Hodgkin’s lymphoma) is a malignancy of B lymphocytes, an important cell in the immune system. This malignant B cell is known as the Reed-Sternberg cell.
Arnold Freedman, MD, clinical director of the Dana-Farber/Brigham and Women’s Cancer Center Adult Lymphoma Program, answers some questions about the disease:
1. What are the different types of Hodgkin lymphoma? There are two main types:
- Classical – This is the most common form, which can be broken down into four subtypes, including nodular sclerosing, mixed cellularity, lymphocyte depletion, and lymphocyte-rich.
- Nodular lymphocyte-predominant (NLPHL) – A rare form of Hodgkin lymphoma that is a slow-growing disease.
2. What are the risk factors for Hodgkin lymphoma? Age and gender can increase the chance of developing Hodgkin lymphoma. Other risk factors include:
- Being in young or late adulthood
- Being male
- Being exposed to the Epstein-Barr virus
- Having a first-degree relative (parent or sibling) with Hodgkin lymphoma
3. What are the symptoms of Hodgkin lymphoma? The most common signs of Hodgkin lymphoma are swollen (painless) lymph nodes in the neck, underarm, or groin, as well as fever, night sweats and weight loss. Other symptoms can include itchy skin, fatigue, cough or shortness of breath.
4. How do doctors diagnose Hodgkin lymphoma? Typically, the doctor will first conduct a physical exam to check for signs of health and any unusual lumps. The doctor will also check routine blood tests and perform scans, such as a CT scan or MRI.
A biopsy of involved tissue or lymph nodes is essential to make a diagnosis. A pathologist then examines the lymph node tissue to look for the malignant B cells.
A doctor may decide to run additional blood tests, including a blood chemistry study and a check for erythrocyte sedimentation rate.
5. What are the treatment options for Hodgkin lymphoma? There are two main tools used in standard treatment for Hodgkin lymphoma: Chemotherapy and radiation therapy.
Combination chemotherapy is used in both early and advanced stages of the disease, and depending on the stage or extent of disease, radiation therapy is added to parts of the body where there are sites of the disease.
Patients with a recurrence of the disease may be considered for a stem cell transplant. These transplants typically use the patient’s own stem cells.
Clinical trials of new chemotherapy combinations are also an option for patients in all stages of Hodgkin lymphoma, as well as patients with a recurrent form of the disease. Dana-Farber currently has several clinical trials open for Hodgkin lymphoma patients and the National Cancer Institute maintains a list of clinical trials at clinicaltrials.gov.