At UofL Health - Brown Cancer Center and in our Multidisciplinary Blood Cancers, Cellular Therapeutics and Transplant Program, we have a team of experts focused on lymphoma, with a depth of experience and expertise not found elsewhere in the region.

We draw upon the latest and most advanced treatments for all stages of Hodgkin's lymphoma, determining the best approach and communicating every step of the way.

We are constantly working to pioneer new treatments that are effective and have the least impact on your body. Whether you recently have been diagnosed with Hodgkin's lymphoma or have battled the disease for years, we can help.

Facts

Lymphomas are cancers of the lymphoid system, which include the lymph nodes, bone marrow, spleen and thymus. Lymphomas arise from a type of white blood cell called lymphocytes. Hodgkin lymphoma is a form of lymphoma that is notable for large cells with multiple nuclei, called Reed-Sternberg cells. About 10 percent of lymphomas are of the Hodgkin type; the others are called non-Hodgkin lymphoma.

Hodgkin lymphoma is most commonly diagnosed in the teenage years, from 15-19, and it is the most common cancer of teenagers and young adults.

Approximately 1,200 children and adolescents are diagnosed with Hodgkin lymphoma each year in the U.S. There is also a smaller group of older adults diagnosed with Hodgkin lymphoma, with incidence slowly increasing after 55 years old.

Symptoms

Hodgkin lymphoma typically presents with lymph node swelling, primarily in the chest and neck, but also possibly in the armpits, groin and abdomen. Other possible symptoms include weight loss, night sweats and unexplained fevers. Itching can also be a symptom of Hodgkin lymphoma, ranging in intensity from mild to severe.

Diagnosis

Hodgkin lymphoma is diagnosed based on a biopsy of involved lymphoid tissue. A pathologist must look at the tissue under the microscope or perform an experiment called flow cytometry to look for the diagnostic Reed-Sternberg cells. Bone marrow biopsy may also be used to complete staging, in other words, determining the extent of disease. Other studies used for staging and prognostic estimation include complete blood count, CT scans and PET scans. CT and PET scans may be performed together as PET-CT scans.

The stages are from I to IV. Stages I and II indicate less diffuse body involvement of lymphoid or non-lymphoid tissues, and stages III and IV indicate more diffuse involvement of lymphoid and non-lymphoid tissues (see below).

Stage I (early stage): One lymph node region is involved.

Stage II (locally advanced disease): The cancer is in two or more lymph regions on one side of the diaphragm. If the cancer is in one lymph node region plus a nearby area or organ, it is considered E disease.

Stage III (advanced disease): Hodgkin lymphoma involves lymph nodes above and below the diaphragm or one node area and one organ on opposite sides of the diaphragm.

Stage IV (widespread disease): The lymphoma is outside the lymph nodes and spleen and has spread to one or more organs such as bone, bone marrow, skin and other organs.

Treatment

Stage I and II disease is most commonly treated with a combination of chemotherapy and involved field or site (where the disease is located) radiation, though chemotherapy alone is sometimes used.

Stage III and IV disease are typically treated with chemotherapy alone, though radiation may be delivered to bulky sites of disease.

Approximately 80 percent of patients can be cured with the initial line of therapy. Patients who have return of disease after initial treatment or have an inadequate response to treatment may be candidates for stem cell transplantation or clinical trials.

Stem cell transplant

For some patients with inflammatory breast cancer, a stem cell transplant may be an option after initial therapy or if the disease spreads, with the goal to reduce the chance of the cancer returning.

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