Hodgkin lymphoma, also called Hodgkin disease, is a cancer of a part of the immune system called the lymph system, which is made up of lymph tissue. Lymph tissue is in many parts of the body, so Hodgkin lymphoma can start in almost any part of your body. The major sites of lymph tissue are the lymph nodes, spleen, bone marrow, thymus, adenoids and tonsils and the digestive tract.
Hodgkin Lymphoma Symptoms and Diagnosis
The first sign of Hodgkin lymphoma is usually an enlarged lymph node. Hodgkin lymphoma can spread to nearby lymph nodes, and later may spread to the lungs, liver, or bone marrow. The exact cause is unknown. Hodgkin lymphoma differs from non-Hodgkin lymphoma in that Hodgkin lymphoma shows the presence of Reed-Sternberg cells – mature B cells (a type of white blood cell) that are unusually large and malignant.
Hodgkin lymphoma typically affects young adults (people in their 20s). Survival rates have improved in recent decades due to advances in treatment. The 5-year survival rate for all patients diagnosed with Hodgkin lymphoma is now about 86%.
Hodgkin lymphoma diagnostic tests may include:
- physician evaluation and a physical exam
- diagnostic imaging such as a PET/CT scan. The PET/CT hybrid scanner is a state-of-the-art diagnostic imaging system that provides more precise information and localization for many cancers; and does it quicker than conventional PET imaging.
- biopsy — either a bone marrow biopsy to examine blood cells, or a surgical or CT-guided biopsy to obtain lymph node tissue samples. Usually biopsy procedures are not carried out at the initial visit, but arranged for a later date, once we have gathered your other information and imaging.
Hodgkin Lymphoma Multidisciplinary Conference
In our weekly multidisciplinary conferences, we review all of your information with the full blood cancer treatment team. (Lymphoma is classified as a type of blood cancer.) Our radiologists report on your imaging studies and our hematopathologists (pathologists who specialize in blood diseases) review the results of your biopsy. Hematologists, oncologists and radiation oncologists voice their opinions. Together as a team focused solely on you, we reach agreement on the best treatment options for your particular situation.
The specific Hodgkin lymphoma treatment you receive will depend on the sub-type of Hodgkin lymphoma you have, how far it has progressed when your Hodgkin lymphoma treatment starts, how the lymphoma responds to initial treatment, and other factors. It may include:
- Chemotherapy – the use of chemicals, through one or more types of medication, to treat disease. Chemotherapy interferes with cancer cells’ ability to grow. It can be administered intravenously (through an IV), subcutaneously (an injection below the skin), or orally (as a pill to swallow)
- Targeted therapy – the use of medications to target the specific gene mutations present in your Hodgkin lymphoma
- Stem cell transplant – also called bone marrow transplant, in this procedure a donor's stem cells are transfused into your blood. The transplanted stem cells go from your blood to your bone marrow. Through this process, the cells that produced the abnormal cells are replaced with healthy cells that produce normal blood cells.
Types of bone marrow/stem cell transplants:
- Autologous stem cell transplants , which are stem cells that come from your own bone marrow or blood. Doctors extract stem cells from your blood or bone marrow, place them in frozen storage, and re-infuse them back into your body following high-dose chemotherapy to eliminate blood cancers.
- Allogeneic stem cell and bone marrow transplants , which are stem cells that come from matched related donors (siblings, for example), or from matched unrelated donors or donated umbilical cords. As a recognized site of the National Marrow Donor Program, BIDMC has access to an international registry of more than 5 million possible unrelated donors.
Dedicated Stem Cell Lab
Our stem cell/immunotherapy laboratory is a key component of our bone marrow transplantation service. The stem cell lab:
- Excels in the special and meticulous handling of human cells
- Provides expertise in the collection, storage, and manipulation of bone marrow and stem cell products so they are ready to be transplanted (re-infused) into the patient
Hematologic Malignancies/Bone Marrow Transplant (BMT) ProgramOur world-renown hematologists, oncologists, radiation oncologists, radiologists and hematopathologists provide state-of-the-art diagnosis and management for blood cancers, including ALL.