Hodgkin Lymphoma

What it is

Overview

Hodgkin lymphoma (HL) is a highly treatable form of lymphoma that originates in lymphocytes — white blood cells in the immune system. It is distinguished by the presence of Reed-Sternberg cells, large abnormal B cells. HL has bimodal incidence peaks: in young adults (15–35) and again after 55. With modern combination chemotherapy and radiation, cure rates exceed 85–90% even for advanced stages.

Biology

How It Develops

In classical HL, Reed-Sternberg cells arise from germinal center B cells that have lost their B-cell identity due to epigenetic reprogramming. Epstein-Barr virus (EBV) is found in ~30–40% of cases and may contribute to B-cell transformation. NF-κB signaling is constitutively active in Reed-Sternberg cells and drives survival and proliferation. The PD-L1/PD-L2 checkpoint pathway is often amplified, explaining why checkpoint inhibitors are highly effective.

Warning signs

Symptoms

• —Painless swollen lymph nodes in the neck, armpit, or groin
• —Persistent fever, night sweats, and unexplained weight loss ('B symptoms')
• —Fatigue and weakness
• —Itching (pruritus)
• —Cough, chest pain, or shortness of breath (mediastinal involvement)

Detection

Diagnosis Methods

• —CT of chest, abdomen, and pelvis
• —PET scan (critical for staging and treatment response)
• —Lymph node biopsy
• —Bone marrow biopsy (for advanced staging)
• —Blood counts and LDH

Medical care

Treatment Options

• —ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine)
• —BEACOPP (for advanced disease)
• —Brentuximab vedotin (targeted anti-CD30 antibody-drug conjugate)
• —Checkpoint inhibitors (nivolumab, pembrolizumab for relapsed/refractory)
• —Autologous stem cell transplant for relapsed disease
• —Radiation therapy (consolidation)

Data

Statistics

Prevention

Risk Factors

• —EBV infection (mononucleosis history)
• —Family history of Hodgkin lymphoma
• —HIV infection
• —Male sex and specific age groups (15–35, 55+)

Further reading

Resources