Hodgkin Lymphoma—Adult
(Hodgkin Disease—Adult)
Definition
Hodgkin lymphoma is a cancer of the lymphatic system. The lymphatic system drains excess fluid from the blood and protects against infection. Hodgkin lymphoma is different from other forms of lymphoma.
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Causes
Cancer occurs when cells in the body—in this case a type of white blood cell called lymphocyte—divide without control or order. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissue and can spread to other parts of the body. A benign tumor does not invade or spread.
The exact causes that lead to Hodgkin lymphoma are unknown. It is likely related to complex genetic and environmental factors that lead to changes in the immune system. There is some compelling evidence to suggest an association with certain viral infections such as Epstein-Barr virus (EBV) or HIV.
Risk Factors
Hodgkin lymphoma is more common in men and people ages 15-40 and over 55 years of age. Other factors that may increase your chance of Hodgkin lymphoma include:
- Family history
- History of infectious mononucleosis or infection with Epstein-Barr virus, which causes mononucleosis
- Weakened immune system, including infection with HIV or the presence of AIDS
Symptoms
Symptoms include:
- Painless swelling of the lymph nodes in the neck, armpit, or groin
- Persistent fatigue
- Night sweating
- Coughing
- Unexplained fever
- Weight loss
- Itching
- Decreased appetite
Diagnosis
You will be asked about your symptoms and medical history. A physical exam will be done, paying particular attention to your lymph nodes.
Your bodily fluids and tissues may be tested. This can be done with:
- Blood tests
- Lymph node biopsy
Your internal bodily structures may need to be viewed. This can be done with:
Abdominal surgery may be needed to remove the spleen and to biopsy the liver. This is not common because of the accuracy of noninvasive scans.
Treatment
Hodgkin lymphoma is generally considered one of the more curable forms of cancer. Treatment options include:
Chemotherapy and External Radiation Therapy
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
In radiation therapy, radiation is directed at the tumor from a source outside the body to kill the cancer cells.
In many cases, both chemotherapy and radiation are used to treat Hodgkin lymphoma. The choice of treatments will be based on:
- Extent of the disease
- Location of the affected lymph node(s)
- Other factors that your doctor will discuss with you
It is important that you be seen by both the medical oncologist to discuss chemotherapy and the radiation oncologist to discuss the radiation therapy. The best treatment results come from a discussion and integrated approach.
If the cancer does not respond to chemotherapy or radiation, the outcome is usually poor. There are some treatment options available, including:
- Bone marrow transplant —Bone marrow is removed. Large doses of chemotherapy and/or radiation therapy are then applied to kill the cancer cells. After treatment, the bone marrow is replaced via a vein. Transplanted bone marrow may be from your bone marrow that was treated to remove cancer cells or marrow from a healthy donor.
- Peripheral blood stem cell transplant —Stem cells are very immature cells that produce blood cells. They are removed from circulating blood before chemotherapy or radiation treatment and then replaced after treatment.
Splenectomy
Splenectomy is the surgical removal of the spleen, an organ that is part of the lymphatic system. In some cases, splenectomy is recommended in people who have lymphoma.
Prevention
There are no current guidelines for preventing Hodgkin lymphoma because the cause is unknown.
RESOURCES:
American Cancer Society
https://www.cancer.org
Leukemia & Lymphoma Society
http://www.lls.org
CANADIAN RESOURCES:
Canadian Cancer Society
https://www.cancer.ca
Lymphoma Canada
https://www.lymphoma.ca
REFERENCES:
Adult Hodgkin lymphoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/lymphoma/patient/adult-hodgkin-treatment-pdq. Accessed January 28, 2021.
Hodgkin lymphoma. American Cancer Society website. Available at: https://www.cancer.org/cancer/hodgkin-lymphoma.html. Accessed January 28, 2021.
Hodgkin lymphoma (HL). EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T114957/Hodgkin-lymphoma-HL. Accessed January 28, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 1/28/2021