--- title: Hodgkin Lymphoma (HL) url: "https://www.yyhmedical.com/en/guide/blood/hodgkin-lymphoma" type: MedicalWebPage inLanguage: en-US --- # Hodgkin Lymphoma (HL) > Hodgkin lymphoma (HL) is a cancer of the lymphatic system. It is commonly diagnosed in adolescents and young adults but can occur at any age. HL is often highly responsive to treatment, and many patients can achieve long-term remission or cure. ## Overview Hodgkin lymphoma (HL) is a cancer of the lymphatic system that develops from B lymphocytes. HL can occur at any age but is relatively common in adolescents and young adults, with another peak in older adults. HL often begins in one lymph node or a group of lymph nodes, commonly in the neck, above the collarbone, or in the chest. It may then spread through the lymphatic system to other parts of the body. Some people also develop systemic symptoms such as fever, night sweats, or weight loss. Based on its pathological features, HL is mainly classified into **classical Hodgkin lymphoma (cHL)** and **nodular lymphocyte-predominant B-cell lymphoma (NLPBL)**. Classical HL is the most common type. ## Causes and Risk Factors The exact cause of Hodgkin lymphoma is not fully understood. The disease is thought to involve genetic and molecular changes in lymphocytes as well as changes in immune function. Factors associated with an increased risk of HL may include: - **Epstein-Barr virus (EBV):** Some cases of classical HL are associated with EBV, but having an EBV infection does not mean that someone will develop HL. - **Weakened immune system:** People with a weakened or suppressed immune system may have a higher risk. - **Family history:** Having a close relative with HL may increase the risk. - **Age:** HL is more common in adolescents and young adults and also occurs more frequently in some older age groups. Most people with these risk factors do not develop HL, and many people diagnosed with HL have no known risk factors. ## Signs and Symptoms One of the most common signs of HL is **painless swelling of the lymph nodes**, particularly in the neck, above the collarbone, or in the armpit. Other symptoms may include: - Unexplained fever - Drenching night sweats - Unexplained weight loss - Ongoing fatigue or weakness - Itchy skin - Loss of appetite - Cough, chest discomfort, or shortness of breath Unexplained fever, drenching night sweats, and a certain degree of unexplained weight loss are known as **B symptoms** and are important when staging and evaluating HL. Some people with HL have no systemic symptoms in the early stages and may notice only a persistently enlarged lymph node. ## Diagnosis If HL is suspected because of persistent, painless lymph node swelling or other symptoms, a **tissue biopsy** is usually needed to confirm the diagnosis. Imaging and laboratory tests are then used to determine the stage of the disease. ### **Biopsy** A biopsy of an affected lymph node or other tissue is essential for diagnosing HL. The tissue is examined by a pathologist, and immunohistochemistry and other tests are used to determine whether HL is present and identify the specific subtype. When possible, enough tissue is obtained for a complete pathological evaluation. ### **Blood Tests** Blood tests can measure red blood cells, white blood cells, and platelets and assess liver and kidney function, inflammatory markers, and overall health. ### **PET/CT** PET/CT is an important tool for staging HL and assessing treatment response. A PET/CT scan before treatment can help show where lymphoma is located throughout the body. PET/CT may also be performed during or after treatment to evaluate response and help guide further treatment decisions. **CT and Other Imaging Tests** Depending on the individual situation, CT, MRI, or other imaging tests may be used to provide additional information about the location and size of the lymphoma and its relationship to nearby tissues. ### ### **Bone Marrow Tests** Bone marrow biopsy was traditionally used to determine whether HL had spread to the bone marrow. With the widespread use of PET/CT, **bone marrow biopsy is no longer routinely required for every patient with HL**. Whether bone marrow testing is needed depends on PET/CT findings and the individual clinical situation. ## Treatment Treatment for HL depends on several factors, including **the pathological subtype, disease stage, risk factors, age, overall health, and response to treatment**. HL is often highly responsive to treatment. Modern treatment aims not only to control or cure the lymphoma but also to reduce unnecessary treatment and minimize long-term side effects whenever possible. ### **First-Line Treatment** Combination chemotherapy is an important part of first-line treatment for classical HL. Different regimens may be used depending on disease stage, risk factors, and the individual patient. Treatment may include **ABVD-based chemotherapy** or other regimens appropriate for the patient’s disease risk and overall health. For some patients, first-line treatment may also include **targeted therapy or immunotherapy combined with chemotherapy**. The treatment approach is individualized based on the characteristics of the disease and treatment goals. ### ### **PET-Adapted Treatment** Some patients undergo an interim PET/CT scan after several cycles of treatment to evaluate how well the lymphoma is responding. Based on PET/CT findings and other risk factors, the healthcare team may decide whether to continue the same regimen, adjust treatment intensity, or modify the next phase of treatment. This response-adapted approach can help maintain treatment effectiveness while reducing unnecessary treatment and long-term side effects when possible. ### **Radiation Therapy** Radiation therapy may be used for selected patients with HL, particularly in some cases of early-stage disease, bulky disease, or lymphoma involving certain sites. Whether radiation is needed, as well as the treatment area and dose, depends on factors such as disease stage, tumor location and burden, and response to chemotherapy on PET/CT. ### **Relapsed or Refractory HL** Some patients may experience a return of the lymphoma after treatment, while others may not respond adequately to initial therapy. This is known as **relapsed or refractory Hodgkin lymphoma (R/R HL)**. Treatment decisions depend on factors such as previous therapy, duration of remission, location of relapse, age, and overall health. Treatment options may include salvage therapy, targeted therapy, immunotherapy, and hematopoietic stem cell transplantation. ### **Targeted Therapy** Many classical HL cells express a protein called **CD30**. An antibody-drug conjugate called **brentuximab vedotin** targets CD30 and delivers treatment directly to CD30-positive lymphoma cells. This type of therapy may be used in selected patients with newly diagnosed or relapsed/refractory classical HL. ### **Immunotherapy** PD-1 immune checkpoint inhibitors have become an important treatment option for some patients with classical HL. These medications help restore the immune system’s ability to recognize and attack lymphoma cells. Depending on the individual situation, they may be used in some newly diagnosed patients as well as in relapsed or refractory disease. ### **Autologous Hematopoietic Stem Cell Transplantation** For selected patients with relapsed or refractory HL who respond to salvage therapy, **high-dose therapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT)** may be considered. The patient’s own blood-forming stem cells are collected and stored before high-dose chemotherapy. The stored stem cells are then returned to the patient to help restore blood cell production. Whether autologous HSCT is appropriate depends on factors such as treatment response, previous therapies, age, and overall health. ### **Clinical Trials** Treatment for HL continues to evolve. Clinical trials are studying new targeted therapies, immunotherapies, and combinations of different treatment approaches. Clinical trials may be available for newly diagnosed as well as relapsed or refractory HL. Whether a trial is appropriate should be discussed with the healthcare team, including its potential benefits and risks. ## Content attribution (YMYL) - Author: - Medically reviewed by: - Last reviewed: - First published: > --- Original (HTML):https://www.yyhmedical.com/en/guide/blood/hodgkin-lymphoma This is a clean Markdown mirror for large language models; the original page is authoritative.