Lymphoma is a collective term for cancers that originate in the lymphatic system, which is a vital part of the body's immune system. Hodgkin Lymphoma (HL) typically begins in B lymphocytes, a specific type of white blood cell that fights infection.
In India, many people are diagnosed with Hodgkin Lymphoma each year, with the disease being most frequently found in young adults between the ages of 20 and 34. Fortunately, the survival rate for Hodgkin Lymphoma is relatively high, with the average five-year survival rate across all stages being close to 87%, and rising to over 91% for cases detected in a single, confined region (Stage I).
A key characteristic of nearly all Hodgkin Lymphoma cases is the presence of Reed-Sternberg cells—a distinctively large cancer cell type not typically found in non-Hodgkin lymphomas. While the disease often starts in the lymph nodes, it has the potential to spread to almost any organ or tissue, including the liver, bone marrow, and spleen.
The lymphatic system is a network that transports disease-fighting white blood cells throughout the body and includes:
A fluid containing lymphocytes that travels through tiny vessels, helping to combat infection and cancer.
Small, bean-shaped masses located in areas like the neck, underarm, groin, and abdomen. They filter the lymph and store white blood cells to help the body fight illness.
An organ on the left side of the abdomen involved in the development of lymphocytes, storing blood cells, and removing old blood cells.
A small organ in the chest that is critical for making and developing lymphocytes.
Nodes at the back of the throat that store white blood cells.
The material inside bones responsible for producing all blood cells, including white blood cells.
Hodgkin Lymphoma is classified into two main types based on how the lymph cells appear under a microscope and whether Reed-Sternberg cells are present. This classification is essential for doctors to determine the most effective treatment plan.
This is the most common form, accounting for about 95% of cases and is generally the most curable type.
Subtypes of cHL include:
While Hodgkin Lymphoma can affect people with no known risk factors, certain elements may increase a person's likelihood of developing the disease:
It is most common in two distinct age groups: young adults (15 to 40 years old) and older adults (over 55 years old).
Males have a slightly higher chance of developing Hodgkin Lymphoma than females.
A small risk is associated with certain viruses, including:
Having a parent, brother, or sister with Hodgkin Lymphoma increases the risk.
It is important to remember that having risk factors does not guarantee that a person will develop Hodgkin Lymphoma. Any concerns should be discussed with a doctor.
Hodgkin Lymphoma often affects young people between the ages of 16 and 34 who are otherwise healthy. Their robust immune systems can sometimes mask the disease, allowing it to go without noticeable symptoms for an extended period.
When symptoms do occur, they can vary widely, but the most common sign is a painless swelling of the lymph nodes, typically in the neck, underarm, upper chest, abdomen, or groin. Patients often seek medical advice for this swelling, which can lead to a diagnosis.
Please Note: These symptoms are common to many conditions and do not automatically mean you have Hodgkin Lymphoma. However, discussing any new or persistent signs with your doctor is crucial for proper evaluation and to rule out other potential health issues.
A successful outcome in treating Hodgkin Lymphoma is dependent on an accurate and precise diagnosis. The disease can sometimes be challenging to diagnose, making it essential to have a specialist analyse your biopsy.
SSCHRC, for example, has an internationally recognised programme focused exclusively on this disease, ensuring patients benefit from the expertise of specialised doctors called haematopathologists, who focus on diagnosing lymphoma and other blood cancers.
If symptoms suggest Hodgkin Lymphoma, your doctor will perform an examination and ask questions about your general health, lifestyle, and family medical history. One or more of the following tests may be used to confirm a diagnosis and monitor the effectiveness of treatment:
A small tissue sample, or sometimes the entire lymph node, is removed and examined under a microscope.
These provide detailed images of the body to locate affected areas and may include:
Used to assess the function of the liver and kidneys.
An ultrasound of the heart.
A thin needle is used to collect a small sample of cells from the inside of a large bone, such as the hip, for microscopic examination.
Cells from a lymph node, blood, or bone marrow are examined to determine the exact type of Hodgkin Lymphoma cells present.
Measures how well the lungs are working.
In rare instances, Hodgkin Lymphoma may be passed down genetically. If this is a concern, genetic counselling may be appropriate.
Treatment for Hodgkin Lymphoma is highly customised to the patient's individual needs. Because standard chemotherapy can have long-term side effects, particularly for young patients, treatment strategies are continuously being refined to be effective yet less harsh. For young men and women, efforts are made to use therapies that treat the cancer while causing the least possible damage to reproductive organs, thus preserving fertility.
Your doctor will discuss the best treatment options based on factors such as:
One or more of the following therapies may be recommended to treat the cancer or help alleviate symptoms:
This is the primary treatment for Hodgkin Lymphoma, often using a combination of drugs with different properties. For almost all patients, the goal of chemotherapy is a complete cure—to eradicate the disease permanently.
This uses focused beams of energy to destroy cancer cells. Modern techniques and precise targeting allow doctors to deliver the maximum dose of radiation to the tumour while minimising damage to surrounding healthy tissue.
Rather than directly attacking the cancer, these drugs help the body's own immune system fight the disease. Immunotherapies, some of which were pioneered at centres like SSCHRC, may include:
If Hodgkin Lymphoma does not respond to first-line treatments or if it recurs, a stem cell transplant may be recommended. This procedure replaces defective or damaged blood cells. Transplants can be autologous (using the patient's own stem cells) or allogenic (using stem cells from a donor). SSCHRC operates one of the largest bone marrow and stem cell transplant programmes, with high success rates achieved by pioneering the use of less toxic chemotherapy doses.