Overview

Hodgkin’s lymphoma, also called Hodgkin’s disease, is a cancer that develops in the lymphatic system (lymphoma). Lymphatic system is a part of the immune system that focuses on immune responses help protecting the body from infection. There are two main types of lymphoma called Hodgkin lymphoma and Non-Hodgkin lymphoma. As Hodgkin’s lymphoma occurs, lymphocytes (white blood cells) have an uncontrollable growth causing swollen lymph nodes in the parts of the body. The advanced diagnosis and treatment of Hodgkin’s lymphoma can lead to a complete recovery.

Symptoms

  • Painless, swollen lymph nodes in the neck, underarms or groin
  • Fatigue
  • Fever
  • Night sweats
  • Unintentional weight loss
  • Severe itching
  • Painful lymph nodes after alcohol consumption

If these symptoms persist, consult your doctor.

Causes

The cause of Hodgkin’s lymphoma is still unclear. Hodgkin’s lymphoma develops when white blood cells that fight against infections known as lymphocytes change in their DNA which instruct a cell on its behavior. The alterations in the DNA instruct the cells to multiply. The cells grow and multiply rapidly while normal cells die. Lymphoma cells pull numerous healthy cells from the immune system for their protection and growth. The excess cells accumulate in the lymph nodes and cause them to be swollen.

There are many types of Hodgkin’s lymphoma. Each type is classified by characteristics and behaviors of the cells that are associated with the disease. The treatment method that will be used depends on the type of lymphoma the patient has.

Classical Hodgkin’s lymphoma
Classical Hodgkin’s lymphoma is the most common where large lymphoma cells known as Reed-Sternberg cells appear in the lymph nodes.
The following are the subtypes of classical Hodgkin’s lymphoma:

  • Nodular sclerosis Hodgkin’s lymphoma
  • Mixed cellularity Hodgkin’s lymphoma
  • Lymphocyte-depleted Hodgkin’s lymphoma
  • Lymphocyte-rich Hodgkin’s lymphoma
  • Nodular lymphocyte-predominant Hodgkin’s lymphoma

Nodular lymphocyte-predominant Hodgkin’s lymphoma
Nodular lymphocyte-predominant Hodgkin’s lymphoma is quite an uncommon type of Hodgkin’s lymphoma that is associated with lymphoma cells called popcorn cells. This disease is often detected at an initial stage and may not require intensive treatments

Risk factors

  • Age. Hodgkin’s lymphoma tends to occur with patients in their 20s and 30s as well as those who are over 55 years old.
  • Having a history of lymphoma in the family. Having a parent, brother, or sister with the disease could raise the risk of Hodgkin’s lymphoma.
  • Gender. Male are more at risk of developing Hodgkin’s lymphoma than females.
  • Record of Epstein-Barr infection. Patients who had the Epstein-Barr virus, such as infectious mononucleosis have higher risk.
  • HIV infection increases the risk of having Hodgkin’s lymphoma.

Diagnosis

  • Physical examination and medical history will be required. Doctors will look for swollen lymph nodes in the neck, underarm and groin, as well as if the spleen or liver are swollen.
  • Blood tests will be done in a lab. The result will indicate the overall condition of health.
  • Imaging tests will indicate signs of Hodgkin’s lymphoma in other parts of the body. The tests may require X-ray, computed tomography (CT) scan and positron emission tomography (PET).
  • Lymph node biopsy may be suggested for analysis in the laboratory if there are any signs of cancer.
    Additional lab tests will analyze the lymphoma cells for markers on the surface that could indicate the type of Hodgkin’s lymphoma to determine the treatment options.
  • Bone marrow biopsy and aspiration is a procedure that collects a sample of bone marrow which is done by inserting a needle into the hipbone. The sample will then be analyzed for discovering Hodgkin’s lymphoma cells.

Hodgkin’s lymphoma stages

The information acquired from the tests will be used to assign the stage of Hodgkin’s lymphoma. The stage will indicate the severity of the disease and determine the treatment needed. The stage will be signified numerically from 1 to 4. The lower shows that cancer is at an initial stage and has high chance of cure, while higher show an advanced stage of the cancer.

In certain cases, Hodgkin’s lymphoma is staged by letters A and B. The letter A indicates that patients do not have alarming symptoms of cancer. The letter B, on the other hand, means there are signs and symptoms of cancer. For instance, a fever that persists, unintentional weight loss and night sweats.

Treatment

Hodgkin’s lymphoma is treated with the objective of cure. The appropriate treatment method varies on the type and stage of the cancer, as well as the patient’s overall health.

Chemotherapy

Chemotherapy is the use of drug treatment that kills lymphoma cells with the help of chemicals. The drugs pass through the bloodstream to the body. Chemotherapy can be taken orally or intravenously. In some cases, both methods are given to the patients. Usually, the treatment of classical Hodgkin’s lymphoma starts with chemotherapy. The disease may require only chemotherapy as a treatment option or it may need to be combined with radiation therapy. A combination of chemotherapy, targeted therapy, and radiation therapy are often administered to treat nodular lymphocyte-predominant Hodgkin’s lymphoma.

Side effects of chemotherapy vary on the type of drugs the patients received. Nausea and hair loss are side effects that are frequently found. Possible complications in the long run may be heart disease, lung damage, fertility problems and other cancers.

Radiation therapy

Radiation therapy relies on powerful beams of energy, such as X-rays and protons, to destroy cancer cells. The energy beams are applied through a machine that surrounds the body while the patient is lying on a table. The energy beams are directed to particular parts of the body.

To treat Hodgkin’s lymphoma, radiation will be directed to the lymph nodes and other areas that have been affected. Radiation therapy is usually given by combining with chemotherapy.

If nodular lymphocyte-predominant Hodgkin’s lymphoma is at an early stage, radiation therapy could only be the treatment required.

The side effects of radiation therapy are fatigue and redness of skin where the radiation is given. When radiation is directed to the neck, it can result in dry mouth and thyroid problems, such as hypothyroidism. Problems with heart and lung may arise if radiation is aimed at the chest.

Bone marrow transplant (Stem cell transplant)

Bone marrow transplant or stem cell transplant replaces diseased bone marrow with healthy stem cells, helping with the growth of new bone marrow. In case when Hodgkin’s lymphoma recurs or has failed with other treatments, bone marrow transplant becomes an option to consider.

A bone marrow transplant is done by removing blood stem cells of the patient, freezing and storing them for later. A high-dose chemotherapy and radiation therapy will be administered to kill cancerous cells in the body. Then lastly the frozen stem cells will be thawed and infused back into the body to build up healthy bone marrow.

Other therapy

  • Targeted therapy: Targeted therapy is often implemented along with chemotherapy when treating nodular lymphocyte-predominant Hodgkin’s lymphoma. For classical Hodgkin’s lymphoma, it is only an option in some cases.
  • Immunotherapy is an option used when the disease not respond to other treatments. Immunotherapy is a treatment that uses drugs to aid the immune system in fighting against cancer. Naturally, the immune system is unable to harm cancer because cancer cells create proteins that the immune system cannot detect. Immunotherapy interferes with this natural process.

Doctors who treat this condition