Hodgkin Lymphoma: Symptoms, Causes & Treatment

Learn about Hodgkin Lymphoma symptoms, causes, and available treatments. That is a group of blood cancers that form in white blood cells called lymphocytes.

Hodgkin Lymphoma: Symptoms, Causes & Treatment

  • Category

    Cancer

  • Published By

    GetWellGo Team

  • Updated on

    22-Apr-2025

What is Hodgkin lymphoma?

Hodgkin lymphoma is commonly referred to as Hodgkin’s disease and it occurs when abnormal lymphocytes transform into cancer cells in the body’s lymphatic system. The Lymphatic System is the performer that has responsibility to fight diseases and germs in your body and causes absorption of water from the tissues that is made of lymph nodes – small glands, the spleen, thymus, and bone marrow.

In Hodgkin lymphoma:

  • There is an abnormal growth of a kind of blood cell known as lymphocytes.
  • Most of it forms nodules in the lymph nodes.
  • In Hodgkin lymphoma, there is a unique type of abnormal cell called the Reed-Sternberg cell that aids the diagnosis of the disease.

Hodgkin Lymphoma Symptoms

Common symptoms of Hodgkin lymphoma:

  • Painless swelling of lymph nodes (especially in the neck, armpits, or groin)
  • The common symptoms include constant exhaustion or feeling constantly tired.
  • Fever that fluctuates without any definite cause of the infection.
  • Night sweats mean sweating heavily during the night such that the clothes or the sheets may become wet.
  • The syndrome may be characterised by a loss of more than 10% of body weight over a period of 6 months without a conspicuous or satisfactory reason.
  • Itchy skin (without rash)
  • Coughing, difficulty in breathing or experiences chest pain especially if the lymph nodes are located on the chest area.
  • Decreased appetite
  • Increased sensitivity to alcohol for example pain in lymph nodes after consumption of alcohol. Although this is a very rare sign but common to Hodgkin lymphoma.

Hodgkin Lymphoma Treatment

Hodgkin lymphoma treatment depends with the stage of the disease, the health of the person, the symptoms which may be present as well as with the type of disease. However, here are general concepts of the main kinds of treatments:

1. Chemotherapy

  • Main treatment for most people.
  • Refers to drugs that act as carcinocides that is drugs that can eliminate cancer cells all over a certain body part.
  • For remission, the most frequent standard cycles are ABVD (Adriamycin/Vinblastine, Bleomycin, Dacarbazine).
  • Equated to cycles over months in the following manner.

2. Radiation Therapy

  • Sometimes it is applied after chemotherapy that results from the cancer attack are only seen in several lymph nodes.
  • Aim to destroy all cancerous cells while sparing the normal cells present in the rays’ pathway.
  • Modern methods are more directed towards reducing side effects.

3. Combined Modality Therapy

  • A mix of chemotherapy plus radiation.
  • Very effective for early-stage Hodgkin lymphoma.

4. Stem Cell Transplant

  • If Hodgkin lymphoma is recurrent or failed to respond to the first-line therapy.
  • This therapy consists of injecting high intensive doses of chemotherapy to kill cancer and then transplantation of stem cells for producing new healthy blood material.

5. Targeted Therapy and Immunotherapy

  • In difficult cases newer treatments are used to “enhance” the immune response against tumors/cancer cells or to “interfere” with the capability of the cancer cell to grow.
  • Examples: Brentuximab vedotin, checkpoint inhibitors like nivolumab and pembrolizumab.

Early Signs of Hodgkin Lymphoma

The early signs of Hodgkin lymphoma are often subtle and easy to mistake for something less serious, like a cold or flu. Here's what to watch for:

  • Painless swelling of lymph nodes
  • Fatigue 
  • Fever 
  • Night sweats
  • Unexplained weight loss 
  • Persistent cough, chest pain, or shortness of breath
  • Itchy skin 
  • Loss of appetite

Hodgkin vs Non-Hodgkin Lymphoma

Feature

Hodgkin Lymphoma

Non-Hodgkin Lymphoma

Key Cell

Presence of Reed-Sternberg cells (large abnormal cells seen under a microscope)

No Reed-Sternberg cells; many different types of abnormal lymphocytes

Common Age

Mostly young adults (15–40 years) and older adults (over 55)

Can happen at any age, but more common as people get older

How it Spreads

Usually spreads in a predictable pattern (from one lymph node group to another nearby)

Often spreads randomly and can involve organs like liver, brain, or bone marrow early

Symptoms

Swollen lymph nodes, fever, night sweats, weight loss, fatigue, itchy skin

Similar symptoms, but can vary more depending on the type

Curability

Often highly curable, especially if diagnosed early

Curability depends a lot on the type (some types grow very fast, others very slow)

Common Treatment

Chemotherapy and radiation; very effective

Treatment depends on the specific type — can include chemo, radiation, immunotherapy, targeted therapy

 

 

Causes of Hodgkin Lymphoma

The cause of Hodgkin lymphoma is not certain but there truth is that several factors that could lead to its development. Here’s a breakdown:

1. Viral Infections

  • While many forms of the cancer are caused by Epstein-Barr virus (EBV), the virus that is responsible for mononucleosis or “mono” is also involved in the development of so many types of the disease.
  • People who have had EBV infection in the past are at a higher risk; however, most of those, who had mono, will never develop lymphoma.

2. Weakened Immune System

  • Typhoid fever attacks people with health issues such as HIV/AIDS or those who have undergone solid organ transplant and are on immunosuppressive medications.
  • It is therefore suggested that other diseases such as lupus, rheumatoid arthritis might also contribute to the same.

3. Age and Gender

  • Majority occurs among people within the age group 15–40 years and some in the age group above 55 years.
  • Slightly more common in males than females.

4. Family History

  • People who have a brother, sister, or twin with Hodgkin lymphoma have a slightly higher chance of developing the disease themselves.

5. Genetic Factors

  • Other genes can predispose the immune system to act in a certain way and hence place one at a higher risk.

6. Environmental Factors (less clear)

  • Some of their relatives or contacts might be afraid by certain chemicals affecting or infections which are not easily made a direct relationship to it.

Stage 4 Hodgkin Lymphoma Prognosis

Stage 4 Hodgkin Lymphoma is characterized by the cancer spread to body parts other than the lymph nodes and organs including the liver, lungs, bone marrow, etc.

Nevertheless, Stage 4 Hodgkin lymphoma is still considered to be rather favorable compared to many other cancers since the five-year survival rate in Hodgkin lymphoma is particularly high for this kind of cancer.

  • Survival rate for Stage IV Hodgkin is about 60 – 80 percent with the factors such as age, general health status, the symptoms and response to treatment affecting the outcome.
  • It was also observed that people who are below 45 years of age have favorable prognosis.
  • The cure must be proactive involving chemotherapy treatment such as ABVD or BEACOPP and sometimes radiation therapy as well.
  • Paladinumab, ombiscitine and Esan are used if standard therapy isn’t sufficient; other newer modalities are immunotherapy (nivolumab, pembrolizumab).

Survival Rate of Hodgkin Lymphoma

Stage

5-Year Survival Rate

Stage 1 (early, localized)

About 90–95%

Stage 2 (early, with nearby spread)

About 90–95%

Stage 3 (spread to both sides of the diaphragm)

About 80–85%

Stage 4 (spread to organs outside the lymph system)

About 60–80%

Overall 5-year survival rate (all stages combined): around 88–90%.

Hodgkin Lymphoma Stages

The stages of Hodgkin lymphoma define how developed the cancer is that has affected the body. The primary reason of staging is to help doctors in determining which treatment plan has to be taken on the patient. Here's a clear and simple breakdown:

Stage 1

  • Cancerous is located in one lymph node region only (for instance, cervical region).
  • In one single organ (like part of the lung or liver)

Stage 2

  • It is when cancer is in two or more lymph node areas, but these areas are located on the same side of the diaphragm which is a muscle situated below the lungs.
  • In one organ and nearby lymph nodes

Stage 3

  • Cancer is in the lymph nodes on both sides of the diaphragm.
  • (Example: neck and abdomen)
  • It may also have disseminated to other organs such as the spleen.

Stage 4

  • This is characterized by the cancer having reached other organs or tissues of the body such as the lungs, liver or bone marrow.
  • Not just near lymph nodes anymore, but deep inside the body.

Hodgkin Lymphoma Diagnosis

Hodgkin lymphoma can be diagnosing in the following ways. Here is how it is done by most doctors:

1. Physical Exam

  • Doctor examines for swollen lymph nodes (neck, axillary, inguinal).
  • Looks for signs of infection or other causes of swelling

2. Biopsy (the key test)

  • A small piece of the lymph node or a portion of it may be taken
  • A pathologist searches for the Reed-Sternberg cells (rare cells that signify Hodgkin lymphoma disease).

Types of biopsy:

  • Biopsy of an entire node or even an excisional one, if possible shall be considered the best procedure.
  • Needle biopsy (less ideal, but used sometimes)

3. Blood Tests

Check for:

  • Low or high blood cell counts
  • Signs of organ function (liver, kidney)
  • Markers of inflammation (like ESR)

4. Imaging Tests

It is used to find out how much lymphoma is in the body:

  • CT Scan (chest, abdomen, pelvis)
  • They currently use advanced techniques such as PET scan that helps identify areas which are active of the cancer.
  • X-rays (sometimes for chest)

5. Bone marrow test is done only if it is necessary for the diagnosis of any disease.

  • If the doctors suspect that lymphoma has spread to the bone marrow, they may consider making a small bone marrow biopsy.

Hodgkin Lymphoma Chemotherapy

Hodgkin lymphoma chemotherapy employs drugs that are aimed at eliminating cancer cells in the body.

Chemo regimens vary but the most applied one is called ABVD, and it has four drugs in it.

  • Adriamycin (doxorubicin)
  • Bleomycin
  • Vinblastine
  • Dacarbazine

It can be given in cycles in once every few weeks with durations of 4-6 months usually.

Chemo simply destroys many of Hodgkin lymphoma cells and has the ability to cure the disease when used together with radiation if the need arises.

Best Hospital for Lymphoma Treatment

Hodgkin Lymphoma in Young Adults

Hodgkin lymphoma is actually amongst the most frequently diagnosed cancer in the groups of young people aged between 15 and 40 years.

Here’s a simple overview:

Why it happens in Young Adults:

  • Exact reasons aren't fully known.
  • It may be due to prior Epstein-Barr virus (EBV) infection, hereditary factors, low immunity, or genetic mutation.

Symptoms in Young Adults:

  • Painless swelling in lymph nodes (neck, underarm, groin)
  • Fatigue and fever without infection
  • Night sweats
  • Unexplained weight loss
  • Itching (if nodes are in the chest region) or skin rash and cough that cannot be stopped.

Diagnosis:

  • Lymph node biopsy is usually done as affirmation.
  • Scans encompass the stage and extent like PET-CT scans.

Treatment:

  • Chemotherapy with ABVD regimen is considered to be the main type of this treatment.
  • At times, it may also be accompanied by radiation therapy if the case calls for it.
  • The newer drugs which are used are in immunotherapy if the disease recurs.
  • There are many patients with the infection, especially young adults, and there is normally high treatment compliance as most are usually cured.

Prognosis:

  • It has remarkable cure rates, frequently, over 90 % if the treatment is commenced in the early stages.
  • Some of the side effects of treatment that were long-term previously such as the possibility of being infertile or an increased heart problem are well monitored today with modern therapies.


 

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