What is Hodgkin lymphoma?
Hodgkin lymphoma, also known as Hodgkin’s lymphoma or Hodgkin disease, is a type of lymphoma. It impacts lymphocytes, the white blood cells that travel through the blood and bone marrow to control your immune system and fight infections.
Lymphocytes are commonly found within lymph nodes, the main part of the body’s drainage system, though they may be found in other tissues. Hodgkin lymphoma differs from non-Hodgkin lymphoma because it has a specific kind of abnormal lymphocyte called a Reed-Sternberg cell, which can be detected by pathologists experienced in evaluating tissue samples taken during a biopsy.
Penn Medicine blood cancer care is nationally recognized for excellence and among the few in the nation approved and supported by the National Cancer Institute. Our program includes sub-specialists who focus solely on lymphoma diagnosis and treatment, so you’ll receive expert care for Hodgkin lymphoma throughout your care journey.
Symptoms of Hodgkin lymphoma
Enlarged lymph nodes are the most common sign of Hodgkin lymphoma, though swollen nodes can happen with other conditions too. This includes different kinds of lymphoma, other cancers, inflammatory diseases, and infections.
Additional symptoms of Hodgkin lymphoma can include:
- Night sweats
- Unexplained weight loss
- Fever
- Chills
- Low energy level
- Cough or shortness of breath
Who is at risk for Hodgkin lymphoma?
Though the cause of Hodgkin lymphoma is not completely clear, there may be some factors that increase a person’s risk of developing it. They include:
- Age: Hodgkin lymphoma is most common in younger people aged 20 to 30 and in older adults.
- Immunosuppressed people: Those with immune system disorders or who take medications that weaken the immune system may be at increased risk.
- Viruses: Both human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV), which causes infectious mononucleosis (“mono”), may play a role in the development of the disease.
There are about 7,800 new cases of Hodgkin lymphoma diagnosed in the United States each year.
Diagnosing Hodgkin lymphoma
Your care team will review your medical history and perform a physical exam that focuses on swollen lymph nodes throughout your body. If lymphoma is suspected, a surgical lymph node biopsy, rather than a needle biopsy, is often recommended to make a diagnosis. This approach is preferred because the characteristic Reed-Sternberg cells may be hard to find in a smaller tissue sample.
Lymphoma diagnostics also include blood and imaging tests that provide information about the type and extent of Hodgkin disease. For example, a complete blood count (CBC) helps examine your white blood cells and red blood cells and platelets, while imaging tests can help identify the location of the lymphoma and stage the disease.
Using staging to guide Hodgkin disease care
As part of your diagnosis, your care team will identify the stage of lymphoma. This includes finding the disease location, which may be in more than one area of the body. Accurate staging helps your care team create the most effective treatment plan.
Hodgkin lymphoma has four different stages as classified by the Modified Ann Arbor Staging System.
- Stage I: A single lymph node region or organ is involved with disease.
- Stage II: Two or more lymph node regions are involved on the same side of the diaphragm, the muscle that controls breathing and separates the chest from the abdomen.
- Stage III: Lymph node regions are involved on both sides of the diaphragm.
- Stage IV: Significant involvement of an organ that is not considered part of the lymphatic system (like the lung or liver) or any organ involvement along with lymph node involvement.
A letter may be added to each stage to refine the diagnosis and provide further information about the disease, for example: stage IIa. These designations include:
- “A”: No worrisome additional symptoms
- “B”: Unexplained fevers, chills, drenching night sweats, weight loss, or fatigue
- “E”: Cancer that has spread from an affected lymph node to an adjacent organ
- “X”: Large or bulky tumors in other areas, frequently found in the chest
Hodgkin lymphoma treatment from leading experts
Hodgkin lymphoma is curable with standard lymphoma treatments like chemotherapy and radiation therapy, often delivering good results. Surgery is rarely required.
Because Hodgkin lymphoma affects a younger population, our hematologist-oncologists and other treatment specialists in our blood cancer care program also work closely with Penn Medicine’s fertility care specialists to help people preserve their fertility as they recover.
Dedicated care from lymphoma specialists
Our blood cancer care teams are national leaders in diagnosing and treating people with blood cancer, including Hodgkin lymphoma, often providing access to clinical trials not widely available elsewhere. We continually advance our understanding of the latest treatment options with a strong focus on groundbreaking research.
Some key areas of focus include:
- Nearly 100 active clinical trials in blood cancer
- The largest stem cell (bone marrow) transplant program across Pennsylvania and New Jersey, treating approximately 300 people a year.
- Partnerships with the National Institutes of Health, the National Marrow Donor Program, and the International Bone Marrow Transplant Registry/Autologous Blood and Marrow Transplant Registry (known as the CIBMTR) in recognition of our work in blood and bone marrow care
- Newer, safer treatments for older people who previously had limited options due to toxicity concerns
With our commitment to advancing research, we strive to bring the most comprehensive and up-to-date care to those with blood cancer, providing treatments tailored to your needs along with compassionate support every step of the way.
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