Similar yet different: Hodgkin versus non-Hodgkin lymphoma

July 20, 2022 | by Samir Undevia, MD

It can be easy to be confused by Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). These two diseases may sound similar, but these cancers have distinct differences.

Both originate in a type of white blood cell in your immune system known as a lymphocyte. Lymphocytes help your immune system remain strong by protecting your body from germs. When your doctor says you have a weakened immune system that means there aren’t enough white blood cells in your bloodstream to help keep you healthy.

Lymphomas are caused by cancerous lymphocytes. Hodgkin lymphoma and NHL are two main types of lymphoma. While both cancers develop in your immune system, the primary difference in the lymphomas is the presence of a specific abnormal cell found in the biopsy.

Your doctor can tell the type of lymphoma you have by using a microscope to look for Reed-Sternberg cells. Reed-Sternberg cells appear in people with Hodgkin lymphoma, and the number of these cells increase as the disease advances. NHL does not feature Reed-Sternberg cells.

Both diseases are relatively rare, but non-Hodgkin lymphoma is far more common overall, and there are more than 60 distinct types of NHL.

Are the symptoms of Hodgkin and non-Hodgkin lymphoma different?

Though the symptoms of Hodgkin and non-Hodgkin lymphoma can be difficult to detect, both diseases include painless swelling of lymph nodes that can be found anywhere in your body. Hodgkin lymphoma is more likely to begin in lymph nodes in your upper body, such as your neck, underarms and chest. Both types of lymphoma may also be associated with other symptoms like extreme fatigue, loss of appetite, weight loss, fevers and night sweats.

Who is at risk for Hodgkin and non-Hodgkin lymphoma?

Age is the most common type of risk factor between Hodgkin and non-Hodgkin lymphoma. The average age of someone who is diagnosed with non-Hodgkin lymphoma is 60, while most Hodgkin lymphomas occur in people ages 15 to 24, or over 60.

What are the treatment options for both lymphomas?

The type of lymphoma, its location and extent in the body determines your prognosis and treatment options. Many people treated for both lymphomas receive some form of chemotherapy, radiation therapy, immunotherapy, targeted drug therapy, or a combination of them all. Bone marrow or stem cell transplantation may also be done under special circumstances.

What is the prognosis like for each?

Hodgkin lymphoma is considered one of the most treatable cancers, with more than 90 percent of patients surviving more than five years. Most patients with Hodgkin lymphoma live long and healthy lives following successful treatment.

Although slow growing forms of NHL are currently not curable, the prognosis is still good. In certain patients, treatment may not be necessary until there are signs of progression.

Are research studies ongoing?

Researchers continue to discover more about how lymphoma begins, as well as other treatment options. Clinical trials are underway to find better ways of reducing symptoms and side effects of both lymphomas.

Learn more about cancer care at Edward-Elmhurst Health.

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