From the Guidelines
Hodgkin lymphoma and non-Hodgkin lymphoma are two distinct types of cancer affecting the lymphatic system, with Hodgkin lymphoma being characterized by the presence of Reed-Sternberg cells and having a better prognosis compared to non-Hodgkin lymphoma. The main difference between the two lies in the presence of these specific cells, which are large, abnormal lymphocytes with a distinctive appearance under a microscope, resembling owl's eyes with multiple nuclei 1. Non-Hodgkin lymphoma, on the other hand, lacks these cells and encompasses a diverse group of lymphomas with varying cell types.
Key Differences
- Hodgkin lymphoma typically spreads in a predictable, orderly fashion from one lymph node group to adjacent ones, whereas non-Hodgkin lymphoma often spreads unpredictably throughout the body.
- Demographically, Hodgkin lymphoma shows a bimodal age distribution, commonly affecting young adults (15-35 years) and older adults (over 55), as noted in the NCCN guidelines for HL 1.
- Treatment outcomes also differ, with Hodgkin lymphoma generally having better prognosis and higher cure rates, often exceeding 80% for all patients, as stated in the NCCN guidelines for HL 1.
- Treatment approaches vary based on the specific type, stage, and individual patient factors, but typically involve chemotherapy regimens like ABVD for Hodgkin lymphoma and R-CHOP for many non-Hodgkin lymphomas, sometimes combined with radiation therapy.
Treatment and Prognosis
The NCCN guidelines for HL discuss the clinical management of patients with CHL and NLPHL, focusing on adult patients 18 years and older who do not have serious intercurrent disease 1. The guidelines emphasize the importance of individualized treatment, particularly for older patients and those with concomitant disease. With the advent of more effective treatment options, 5-year survival rates for Hodgkin lymphoma have improved significantly, making it curable in at least 80% of patients 1. The overriding treatment considerations often relate to long-term toxicity, especially for patients with early- or intermediate-stage disease, highlighting the need for careful management and consideration of potential long-term effects of treatment 1.
From the Research
Key Differences
- Hodgkin lymphoma and non-Hodgkin lymphoma are two distinct types of lymphoma, with different characteristics, symptoms, and treatment approaches 2, 3, 4.
- Hodgkin lymphoma is typically treated with combined chemotherapy, such as ABVD, Stanford V, or BEACOPP, often accompanied by radiotherapy 2.
- Non-Hodgkin lymphoma, on the other hand, is treated with chemotherapy regimens like CHOP, with or without rituximab, bendamustine, and lenalidomide 2.
Similarities and Distinctions
- Both Hodgkin and non-Hodgkin lymphoma present with similar symptoms, such as painless adenopathy, fever, unexplained weight loss, and night sweats 2, 3, 4.
- The presence of Reed-Sternberg cells is a hallmark of classic Hodgkin lymphoma, but similar cells, known as Reed-Sternberg-like cells, can also be found in non-Hodgkin lymphoma 5.
- The age of presentation differs significantly between the two types of lymphoma, with non-Hodgkin lymphoma having a higher number of subtypes 4.
Diagnostic and Therapeutic Considerations
- An open lymph node biopsy is the preferred method for diagnosing lymphoma, and the Lugano classification system is used to stage the disease 2.
- Treatment plans differ between Hodgkin and non-Hodgkin lymphoma, and subsequent chemotherapy toxicities, such as neuropathy, cardiotoxicity, and secondary cancers, should be considered in the treatment selection process 2.
- Patients with lymphoma require routine surveillance to monitor for complications and relapse, as well as age-appropriate screenings and vaccinations 2.