Reviewed By: Pramod Kerkar, MD, FFARCSI

Hodgkin’s disease is an uncommon type of blood cancer or lymphoma that occurs in the lymphatic system. Hodgkin’s disease is rare, as only 8500 people in the United States of America and only 550 people in Australia are diagnosed with this disease or this type of lymphoma every year. Since the lymphatic system is associated with fighting infection and getting rid of the wastes through the immune system, with Hodgkin’s disease, this system gets disrupted.

What is Hodgkin’s Disease?

What is Hodgkin’s Disease?

Hodgkin’s disease, better known as Hodgkin’s lymphoma is a cancer that affects the lymphatic system. Like every other lymphoma, Hodgkin’s disease is also a condition in which the lymphocytes or lymph node cells get multiplied uncontrollably. Hodgkin’s disease starts to produce malignant lymphocytes and gradually invades through other body tissues. Hodgkin’s disease or Hodgkin’s lymphoma compromises the ability of the body to fight infection.

What are the Types of Hodgkin’s Disease?

Depending on the appearance of the malignant cell or lymph node biopsy specimen under the microscope and Reed-Sternberg Morphology, as well as the reactive cell infiltrate composition, the difference of growth and spread of Hodgkin’s disease or Hodgkin’s lymphoma can be categorised in two main types and these are Classic Hodgkin’s disease and the Nodular lymphocyte predominant Hodgkin’s disease.

Type-I: Classic Hodgkin’s Disease

In Classic Hodgkin’s disease an abnormal type of B lymphocytes, which are much larger than normal lymphocytes, grow rapidly. These cells are called Reed-Sternberg cells. About 95% of all Hodgkin’s disease cases are of this type. There are four subtypes of Classic Hodgkin’s disease and they are:

Nodular Sclerosis Hodgkin’s disease: About 60% to 80% of all Hodgkin’s disease cases are of this type. Occurring mostly in teens and young adults, the lymph nodes in the neck or chest are affected mostly in nodular sclerosis Hodgkin’s disease.

Lymphocyte-Rich Hodgkin’s Disease: About 5% of all Hodgkin’s disease cases are of this type. In this type of Hodgkin’s disease, few of the lymph nodes in the upper half of the body are affected.

Mixed Cellularity Hodgkin’s Disease: About 15% to 30% of all Hodgkin’s disease cases are of this type. Mixed Cellularity Hodgkin’s Disease too affects the lymph nodes, mostly in the upper part of the body, but it can also affect the lymph nodes in any of the other body parts.

Lymphocyte-Depleted Hodgkin Disease: This is an extremely rare type of Classic Hodgkin’s disease occurring in less than 1% of Hodgkin’s disease cases. When Lymphocyte-Depleted Hodgkin Disease is diagnosed, it reaches almost its advanced stage and affects the lymph nodes spleen, liver, abdomen and bone marrow.

Type-II: Nodular Lymphocyte Predominant Hodgkin’s Disease

This type of Hodgkin’s lymphoma occurs in 5% of all the cases. The cancerous cells in Nodular Lymphocyte Predominant Hodgkin’s Disease are called popcorn cells. Men are found to have Nodular Lymphocyte Predominant Hodgkin’s Disease more than women and the lymph nodes under the arms and around the neck are affected more in this type of Hodgkin’s disease.

What are the Causes & Risk Factors of Hodgkin’s Disease?

The cause of Hodgkin’s disease or Hodgkin’s lymphoma is not clear. However, the possible causes and risk factors of Hodgkin’s disease include:

  • The Epstein-Barr virus that has been found in 20% to 80% of Hodgkin lymphoma tumors.
  • When at early stage, the children are not exposed much to bacterial and viral infection, they have a high possibility of getting Hodgkin’s disease or Hodgkin’s lymphoma.
  • Children, who have fewer siblings, are more likely to get Hodgkin’s disease or Hodgkin’s lymphoma.
  • Those who have parents suffering from Hodgkin’s disease are more likely to get this disease.
  • Children with identical twins and same-sex siblings are at higher risk for getting Hodgkin’s disease or Hodgkin’s lymphoma.

What are the Signs & Symptoms of Hodgkin’s Disease?

When Hodgkin’s disease occurs, the usual signs and symptoms associated with this disease that are expressed are:

  • Painless swelling of lymph nodes in armpits, neck and groin.
  • Fever and chills.
  • Loss of appetite.
  • Unexplained weight loss.
  • Persistent fatigue.
  • Itching.
  • Night sweats.
  • Increased sensitivity and pain in lymph nodes after drinking alcohol.
  • Feeling of breathlessness.
  • Persistent cough and cold.
  • Difficulty in recovering from infection.

How is the Staging of Hodgkin’s Disease Done?

Depending on how much the Hodgkin’s disease or Hodgkin’s lymphoma has spread, the stages of this disease can be determined and they are:

Stage-I Hodgkin’s disease: When one single lymph node region is affected, it is referred as 1st stage of Hodgkin’s disease.

Stage-II Hodgkin’s disease: When two or more lymph node regions on the same diaphragm side are affected then it is referred as 2nd stage of Hodgkin’s disease.

Stage III Hodgkin’s disease: When both sides of the diaphragm involving several lymph nodes are affected, then it is classified as the 3rd stage of Hodgkin’s disease.

Stage IV Hodgkin’s disease: When the Hodgkin’s disease involves one or more than one extra-lymphatic organ, then it is known as the 4th stage of Hodgkin’s disease.

How is Hodgkin’s Disease Diagnosed?

The Hodgkin’s disease or Hodgkin’s lymphoma can be diagnosed at first with some physical tests. If the signs and symptoms show a possibility of this disease, the doctor recommends a few further tests and they are:

Blood Tests: A sample of your blood is collected to check for any abnormality.

Imaging Tests: X-ray, positron emission tomography (PET) and computerized tomography (CT) scan are done to check for the enlarged and swollen lymph nodes.

Biopsy Test: A sample from the lymph node is collected to check for the malignancy and uncontrolled growth of the lymphocytes, in the laboratory.

What is the Treatment for Hodgkin’s Disease?

Based on the stage of Hodgkin’s disease, the treatment is done. The purpose in treatment of Hodgkin’s disease or Hodgkin’s lymphoma is to kill as many malignant cells as possible. The most useful modes of treating Hodgkin’s disease are:

Chemotherapy: It is a drug treatment that is useful in killing the cancer cells in Hodgkin’s disease, as the drug travels through the bloodstream to kill the malignant cells throughout the body.

Radiation: High energy radiation therapy is used to kill the malignant cells of Hodgkin’s disease and also to stop the further production of these malignant cells.

Stem Cell Transplant: When there is recurrence of Hodgkin’s disease, stem cell transplant procedure is chosen. In this process, the diseased bone marrow stem cells are replaced with healthy one.

Epidemiology and Prognosis of Hodgkin’s Disease

Hodgkin’s disease or Hodgkin’s lymphoma occurs in separate age groups – one in early adulthood that is within the age group of 15 to 35 years and the other is above 55 years. Annually Hodgkin’s disease occurs in about 2.7 in every 100,000 persons per year. Over the past few decades, the treatments for Hodgkin’s disease are improving. Hodgkin’s disease or Hodgkin’s lymphoma responds extremely well to chemotherapy, resulting in a five-year survival rate in more than 98% cases that are diagnosed early.
Studies have shown that in the year 1990, globally the death rate due to Hodgkin’s disease was 19,000 and in the year 2010, it was reduced to 18,000. The survival rate from Hodgkin’s disease deteriorates if:

  • The patient’s age is more than or equal to 45 years.
  • If patient’s haemoglobin is less than 10.5 g/dl.
  • If Hodgkin’s disease is diagnosed at Stage IV.
  • If the patient’s albumin level is less than 4.0 g/dl.
  • If you are a male suffering from Hodgkin’s disease.
  • If the patient’s white blood count is more than 15,000/µl.

Complications and Coping in Hodgkin’s Disease

Those who suffer from Hodgkin’s disease or Hodgkin’s lymphoma are often seen to experience some complications like a weak immune system, infertility and other cancers. Since the lymphatic system is associated with fighting with infection, a damaged lymph node and malignant lymphatic system weakens the immune system. The problem of infertility in Hodgkin’s disease is associated with the side effects of its treatment such as chemotherapy and radiation therapy. Sometimes, Hodgkin’s disease or Hodgkin’s lymphoma leads to other kinds of cancers like breast cancer and lung cancer.

The problem with Hodgkin’s disease is that after long term treatments, various side effects occur. It might lead to other kinds of cancer developments. To make sure that other types of cancers do not form, follow-up care is very important in Hodgkin’s disease. For survivors of Hodgkin’s disease; cholesterol tests, regular mammograms and heart disease screenings are very important. With support groups and doctor’s help, patients who have had Hodgkin’s disease can lead a happy life.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: January 3, 2019

This article does not provide medical advice. See disclaimer

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