Adult Hodgkin's Lymphoma Treatment

by National Cancer Institute

Adult Hodgkin's lymphoma is a disease in which malignant (cancer) cells form in the lymph system.

Adult Hodgkin's lymphoma is a type of cancer that develops in the lymph system, part of the body's immune system.

The lymph system is made up of the following:

Lymph: Colorless, watery fluid that travels through the lymph system and carries white blood cells called lymphocytes. Lymphocytes protect the body against infections and the growth of tumors.

Lymph vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.

Lymph nodes: Small, bean-shaped structures that filter substances in lymph and help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.

Spleen: An organ that produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach.

Thymus: An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.

Tonsils: Two small masses of lymph tissue at the back of the throat. The tonsils produce lymphocytes.

Bone marrow: The soft, spongy tissue in the center of large bones. Bone marrow produces white blood cells, red blood cells, and platelets.

Because lymph tissue is found throughout the body, Hodgkin's lymphoma can begin in almost any part of the body and spread to almost any tissue or organ in the body.

Lymphomas are divided into 2 general types: Hodgkin's lymphoma and non-Hodgkin's lymphoma.

Hodgkin's lymphoma can occur in both adults and children; however, treatment for adults may be different than treatment for children. Hodgkin's lymphoma may also occur in patients who have acquired immunodeficiency syndrome (AIDS); these patients require special treatment.

There are 5 different types of Hodgkin's lymphoma. These 5 types are based on the way they look under a microscope.

• Nodular sclerosing Hodgkin's lymphoma.
• Mixed cellularity Hodgkin's lymphoma.
• Lymphocyte depletion Hodgkin's lymphoma.
• Lymphocyte-rich classical Hodgkin's lymphoma.
• Nodular lymphocyte-predominant Hodgkin's lymphoma.

Age, gender, and Epstein-Barr infection can affect the risk of developing adult Hodgkin's lymphoma.

Risk factors for adult Hodgkin's lymphoma include the following:

• Being in young or late adulthood.
• Being male.
• Being infected with the Epstein-Barr virus.
• Having a first-degree relative (parent, brother, or sister) with Hodgkin's lymphoma.

Possible signs of adult Hodgkin's lymphoma include swollen lymph nodes, fever, night sweats, and weight loss.

These and other symptoms may be caused by adult Hodgkin's lymphoma. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems do not go away:

• Painless, swollen lymph nodes in the neck, underarm, or groin.
• Fever for no known reason.
• Drenching night sweats.
• Weight loss for no known reason.
• Itchy skin.
• Feeling very tired.

Tests that examine the lymph nodes are used to detect (find) and diagnose adult Hodgkin's lymphoma.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's past illnesses and treatments will also be taken.

Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:

• The number of red blood cells, white blood cells, and platelets.
• The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
• The portion of the sample made up of red blood cells.

Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it.

Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells. One of the following types of biopsies may be done:

• Excisional biopsy: The removal of an entire lymph node.
• Incisional biopsy or core biopsy: The removal of part of a lymph node.
• Needle biopsy or fine-needle aspiration: The removal of a sample of tissue from a lymph node with a needle.

Immunophenotyping: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to find out if malignant lymphocytes (cancer) began from the B lymphocytes or the T lymphocytes.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• The patient's symptoms.
• The stage of the cancer.
• The type of Hodgkin's lymphoma.
• Blood test results.
• The patient's age, gender, and general health.
• Whether the cancer is recurrent or progressive.

Adult Hodgkin's lymphoma can usually be cured if found and treated early.

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