Hodgkin Lymphoma (also called Hodgkin’s Disease) is a type of cancer that affects lymph nodes. It arises from primitive variants of B type Lymphocytes, which are essential units of the human immune system. Once a B-cell variant turns malignant, it causes other cells to proliferate rapidly, and is called the Reed-Sternberg cell. Other lymphomas of B cell origin are called Non-Hodgkin Lymphomas.
1. What Are The Types Of Hodgkin's Lymphoma?
There are two main types of the disease:
- Classical – This is the most common form of the disease, which can be broken down into 4 subtypes:
- Nodular Sclerosing
- Mixed Cellularity
- Lymphocyte Depletion
- Lymphocyte Rich.
- Nodular Lymphocyte Predominant Hodgkin's Lymphoma (NLPHL) – This is a rare form of Hodgkin's Lymphoma, which grows slowly.
2. Who Is At Risk For Hodgkin's Lymphoma?
Traditionally, Hodgkin's Lymphoma is seen in developed countries. It is seen slightly more in men than women, and is more common among children and young adults as compared to the elderly. It can be seen in both adults and children with a bimodal age distribution at 15-30 years and in the 55+ age group.
Various other factors can also increase the risks of developing Hodgkin's Lymphoma. Such risk factors include:
- Male Predisposition
- Young Adult Age
- Exposure To The Epstein-Barr Virus
- First-Degree Family History of Hodgkin's Lymphoma (Through a parent/sibling)
3. Primary Symptoms Of Hodgkin's Lymphoma
Aside from the more uncommon symptoms, such as itchiness of the skin, persistent fatigue, cough or shortness of breath, the following symptoms are more directly related to the disease. If seen continuously in combination or isolation, they should be checked as signs of Hodgkin's Lymphoma and a doctor should be consulted at the earliest.
- Painless Swollen Lymph Nodes(In the neck, underarm, or groin)
- Persistent Fever with Night Sweats
- Persistent Weight Loss
4. Diagnosis Of Hodgkin's Lymphoma
The first step in the diagnosis of Hodgkin's Lymphoma, is a physical examination to check for any unusual lumps (Swollen Lymph Nodes) in the neck, underarms and groin. This is followed by routine blood tests and imaging scans such as a PET-CT scan to establish size and/or location.
For a confirmed diagnosis, the following steps are observed:
- First, a biopsy of all relevant tissue and/or lymph nodes is performed.
- Next,a pathologist examines the lymph node tissue for the presence of malignant B- Lymphocyte cells (Reed-Sternberg cells).
- A Whole Body PET-CT scan helps in staging the disease.
- In some cases, doctors might run further blood tests such as a Blood chemistry study, and a test to measure ESR (the erythrocyte sedimentation rate).
5. Treatment Options For Hodgkin's Lymphoma
Hodgkin Lymphoma is a cancer condition where there is a minimum 80% chance of getting cured with appropriate treatment. The advent of more effective treatment options has helped achieve this feat.
The primary treatment includes Chemotherapy and Radiation Therapy. In early and advanced stages of Hodgkin Lymphoma, doctors generally use a combination of Chemotherapy drugs.
Patients who have experienced a recurrence of Hodgkin Lymphoma, may require a Stem Cell Transplant. Such transplants (autologous translpants) typically harvest the patient’s own stem cells and reinfuse them into the patient. Additionally, there is hope for patients in more advanced stages, as Monoclonal Antibody based drugs (mAbs) are being introduced in treatments and clinical trials around the world.
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