Hodgkin’s Lymphoma
What Is Hodgkin’s Lymphoma?
Hodgkin’s lymphoma (HL) is a cancer of the lymphatic system—the body’s drainage and immune-defence network. In HL, certain white blood cells (called lymphocytes) start to grow and multiply in an abnormal way. The disease usually begins in a single lymph node—often in the neck or chest—and may spread along connected nodes or into organs such as the spleen, liver, or bone marrow.
Why it matters: the lymphatic system is central to fighting infection, so when it is taken over by cancer cells, the immune system weakens. Fortunately, HL is one of the most curable cancers, especially when caught early and treated by experienced specialists.
Types of Hodgkin’s Lymphoma:
- Classic Hodgkin’s Lymphoma:
This is the most common type of Hodgkin’s Lymphoma. Around 9 out of 10 people with HL have this form. It is called "classic" because it has typical features that doctors recognize under a microscope, especially a special kind of cell called the Reed–Sternberg cell. These are large, abnormal white blood cells that are a hallmark of this cancer.
Classic Hodgkin’s Lymphoma is further divided into four subtypes based on how the cancer cells and surrounding tissues look:- Nodular Sclerosis Hodgkin’s Lymphoma:
- This is the most common subtype.
- It often affects young adults, especially women.
- Doctors can see bands of scar-like tissue (fibrosis) in the lymph nodes.
- The affected lymph nodes are often in the chest or neck area.
- Most people respond very well to treatment.
- Mixed Cellularity Hodgkin’s Lymphoma:
- This type has a variety of different cell types (hence the name “mixed”).
- It is more common in older adults and young children, and also seen in people with weakened immune systems.
- It often shows up in the abdomen.
- It may be more advanced when diagnosed but can still be treated effectively.
- Lymphocyte-Rich Hodgkin’s Lymphoma:
- This is a less common subtype.
- It has many normal lymphocytes and fewer Reed–Sternberg cells.
- Usually found in early stages and may grow slowly.
- Has a very good prognosis and responds well to treatment.
- Lymphocyte-Depleted Hodgkin’s Lymphoma:
- This is the rarest and usually most aggressive subtype.
- It has fewer normal lymphocytes and many abnormal cancer cells.
- Seen more often in older adults or people with HIV/AIDS.
- It may require more intense treatment because it’s often diagnosed at a later stage.
- Nodular Sclerosis Hodgkin’s Lymphoma:
- Nodular Lymphocyte-Predominant Hodgkin’s Lymphoma (NLPHL)
This is a rare and unique form of Hodgkin’s Lymphoma, making up about 5–10% of all HL cases.
Here’s how it’s different from classic HL:- The cancer cells look different from Reed–Sternberg cells. Instead, doctors see “popcorn-shaped” cells under the microscope (officially called LP cells).
- It usually grows more slowly than classic HL.
- NLPHL often affects men more than women and is commonly seen in younger adults.
- It usually starts in just one or two lymph nodes, often in the neck or armpit.
- Sometimes it can be managed with less aggressive treatment or even just regular monitoring if it’s caught very early.
- However, in some cases, it can come back or transform into a more aggressive lymphoma, so follow-up is important.
Risk Factors of Hodgkin’s Lymphoma?
The exact cause of blood cancer isn’t always known. But several factors can increase the chances of developing it.
- Genetic mutations: Changes in DNA that affect how cells grow.
- Family history: If a close family member had blood cancer.
- Radiation exposure: Especially from past cancer treatments or nuclear exposure.
- Chemicals: Long-term exposure to chemicals like benzene.
- Smoking: Increases the risk of certain types of leukemia.
- Weak immune system: Such as from HIV/AIDS or after an organ transplant.
Just having a risk factor doesn’t mean you’ll get blood cancer. Many people with risk factors never get it, and some with no known risks do.
Signs and Symptoms of Blood Cancer
Blood cancer symptoms can look like common illnesses at first — such as tiredness or flu. But when they don’t go away or keep coming back, it’s time to check with a doctor.
- Feeling very tired or weak all the time
- Frequent infections that don’t go away
- Fever or night sweats
- Sudden weight loss without trying
- Swelling in the neck, armpits, or groin (swollen lymph nodes)
- Easy bruising or bleeding (nosebleeds, bleeding gums)
- Pain in bones or joints
- Pale skin
- Shortness of breath
How Blood Cancer is Diagnosed?
1. Physical examination: The first step often begins with a physical examination and a detailed discussion about how the patient has been feeling, what symptoms they’ve experienced, and whether there’s any family history of cancer or serious illness.
2. Blood tests: After this initial consultation, the doctor usually recommends a set of blood tests. One of the most important ones is called a complete blood count (CBC). This test looks at the number and types of cells in your blood — including red blood cells, white blood cells, and platelets these are called as blasts cells. If there are too many or too few of any of these, or if the cells look abnormal, it can be a sign that something is wrong in the bone marrow where these cells are made.
3. Bone marrow/biopsy tests: If the blood test shows unusual results, the next step is to look more closely at the bone marrow — the soft, spongy tissue inside your bones. This is done through a bone marrow biopsy. During this test, a small sample of bone marrow is taken, usually from the hip bone, using a special needle. This might sound scary, but it’s a routine procedure and is done under local anesthesia so the patient doesn’t feel pain. The sample is then sent to a laboratory where it’s checked under a microscope to see if there are any cancer cells present. Special test like flow cytometry, cytogenetics and molecular tests are performed on the bone marrow samples. These tests helps for staging and prognosis.
4. Imaging tests: CT scans, PET scans, or MRIs are also used. These scans give doctors a detailed picture of what’s happening inside the body. For example, if a person has swollen lymph nodes or an enlarged spleen, these tests can help show how far the disease has spread. In some cases, especially if lymphoma is suspected, a lymph node biopsy may be done. This means removing a small part of a swollen lymph node and examining it to see if there are cancer cells in it. The imaging tests help for staging and monitoring the disease response.
Lifestyle Tips During and After Treatment
Fighting cancer isn’t just about medicines. Your lifestyle also plays a big role in how well you respond to treatment and how quickly you recover:
Helpful lifestyle changes:
- Eat healthy food: Include fruits, vegetables, lean protein, and whole grains.
- Drink plenty of water: Stay hydrated.
- Avoid junk food and sugary drinks.
- Don’t smoke or drink alcohol.
- Get gentle exercise: Like walking or light yoga to keep your energy up.
- Take care of your mental health: Talk to a counselor or join a support group.
- Follow-up visits: Never skip checkups — they help detect problems early.
Treatment Options for Blood Cancer
1. Chemotherapy: Chemotherapy uses strong medicines that travel through the bloodstream to reach and destroy cancer cells. These medicines are usually given through a drip (IV) or taken as pills. Chemotherapy works by targeting cells that grow quickly, which includes cancer cells. However, it can also affect some healthy cells, which is why people might feel side effects like hair loss, tiredness, or nausea. But many of these side effects can be managed with proper care, and they often go away after the treatment ends.
2. Targeted Therapy: This is a more advanced form of treatment that focuses only on the cancer cells and leaves the healthy ones alone. Targeted therapy looks for specific markers or changes in the cancer cells and uses special medicines to block those changes. Because it attacks only the bad cells, many people find it easier to tolerate than chemotherapy. It’s like sending a smart missile to destroy the enemy without damaging the surroundings.
3. Immunotherapy: This method helps the body’s own immune system fight the cancer. Normally, your immune system protects you from diseases. But in blood cancer, cancer cells can hide from your immune system or stop it from working properly. Immunotherapy boosts or trains your immune system to recognize and attack cancer cells more effectively.
4. Stem Cell Transplant: This is also known as a bone marrow transplant. In this treatment, the patient first receives high doses of chemotherapy (sometimes radiation too) to destroy all the cancer cells. Then, healthy stem cells are introduced into the body to rebuild the bone marrow and help it produce healthy blood cells again. These stem cells may come from the patient’s own body (collected earlier) or from a donor. It’s a complex procedure, but for many patients, it offers a chance at a complete cure.
5. Radiation Therapy: Radiation therapy is sometimes used in blood cancer treatment, especially in lymphoma. Radiation uses high-energy rays to target and kill cancer cells in specific parts of the body. If a patient has a large tumor or a swollen lymph node that’s causing problems, radiation can help shrink it quickly. It’s usually used along with other treatments like chemotherapy or after a transplant.
6. Cellular Therapy (CAR-T Cell Therapy / BiTE Therapy): This is one of the most promising and cutting-edge options for certain types of blood cancer.
- CAR-T Cell Therapy involves collecting a patient's T-cells (a type of immune cell), modifying them in a lab to recognize and attack cancer cells, and then infusing them back into the patient’s body. It’s highly personalized and has shown remarkable results in treating some leukemias and lymphomas.
- BiTE (Bispecific T-cell Engager) Therapy is another exciting innovation. It uses specially designed antibodies that bind both cancer cells and the patient’s T-cells, bringing them together to destroy the cancer cells directly.
Dr. Reetu Jain is a highly respected blood cancer specialist in Mumbai, known for her compassionate care, deep expertise, and personalized approach to treatment. With years of experience in managing complex cases of leukemia, lymphoma, and multiple myeloma, she is widely regarded as one of the best oncologist in Mumbai. Her dedication to patient care, combined with her use of the latest medical advancements—such as targeted therapy, immunotherapy, and stem cell transplants—makes her a trusted choice for families seeking reliable and effective cancer treatment. Patients often describe Dr. Reetu Jain not only as a skilled blood cancer doctor in Mumbai, but also as a comforting presence during one of the most difficult times in their lives.
Frequently Asked Questions (FAQs)
Yes, many types of blood cancer are curable, especially when diagnosed early. With today’s advanced treatments like chemotherapy, targeted therapy, and stem cell transplants, many patients go into complete remission. However, every case is different. Factors like the type of blood cancer, the stage at diagnosis, and the patient’s overall health all play a role
It’s a common and fair question. Blood cancer doesn’t always have a clear cause. While some cases are linked to genetics, radiation, or chemicals, many people develop it without any known risk factors. It’s not something you caused or could have prevented. Sometimes, random changes in the body’s cells lead to cancer. That’s why regular health checkups and awareness of symptoms are so important.
Yes, unfortunately, blood cancer can affect children as well. In fact, leukemia is one of the most common cancers in children. The good news is that children often respond very well to treatment. Pediatric oncologists work closely with families to provide child-friendly care and support throughout the journey.
Some types of blood cancer can come back, which is called a relapse. However, regular follow-up tests help doctors catch any changes early. If the cancer does return, there are still treatment options available. Many patients go into remission again after further care.
Absolutely. Eating healthy, staying hydrated, getting gentle exercise, and managing stress all help the body heal. Avoiding smoking and alcohol, taking medications on time, and following your doctor’s advice are also important