From the Guidelines
Non-Hodgkin lymphoma and Hodgkin lymphoma are two distinct types of cancer affecting the lymphatic system, with the main difference lying in the presence of Reed-Sternberg cells, which are characteristic of Hodgkin lymphoma, as noted in the most recent guidelines 1. The key distinction between these two types of lymphoma is the presence of Reed-Sternberg cells in Hodgkin lymphoma, which are large, abnormal lymphocytes, whereas non-Hodgkin lymphoma lacks these cells. Hodgkin lymphoma typically spreads in a predictable manner from one lymph node group to adjacent ones, while non-Hodgkin lymphoma spreads more unpredictably throughout the body. Some key characteristics of Hodgkin lymphoma include:
- The presence of Reed-Sternberg cells
- A predictable pattern of spread
- Higher cure rates, especially with early diagnosis
- Treatment approaches that often include specific chemotherapy regimens like ABVD and radiation therapy In contrast, non-Hodgkin lymphoma:
- Lacks Reed-Sternberg cells
- Spreads unpredictably throughout the body
- Includes many subtypes with varying aggressiveness
- Requires treatment approaches that vary widely depending on the subtype, which may include chemotherapy combinations like R-CHOP, targeted therapies, immunotherapies, or stem cell transplantation. According to the most recent guidelines, the WHO classification divides Hodgkin lymphoma into two main types: classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) 1. Some important considerations in the management of Hodgkin lymphoma include:
- Staging and risk assessment, which involve careful evaluation for the presence of B-symptoms, such as fever, night sweats, and weight loss, as well as comprehensive staging procedures, including bone marrow biopsy and CT scans of the abdomen and thorax 1
- Treatment approaches, which may include combined chemoradiotherapy, such as two cycles of ABVD followed by 30 Gy involved field radiotherapy, for patients with early favorable HL 1. The most effective treatment approach for Hodgkin lymphoma is often a combined modality approach, including chemotherapy and radiation therapy, as noted in the most recent guidelines 1.
From the Research
Difference between Non-Hodgkin Lymphoma (NHL) and Hodgkin Lymphoma (HL)
- Non-Hodgkin Lymphoma (NHL) and Hodgkin Lymphoma (HL) are two distinct types of lymphoma, a group of malignant neoplasms of lymphocytes 2.
- NHL is a heterogeneous group of malignancies of the lymphoid system, classified as B-cell and T-cell neoplasms, with B-cell lymphomas accounting for approximately 90% of all lymphomas 3.
- HL is characterized by the presence of Reed-Sternberg cells, which are distinguishing features of classical Hodgkin lymphoma 4, 5.
- The treatment protocols for NHL and HL differ, with NHL treated with chemotherapy regimens such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab, and HL treated with combined chemotherapy with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) or other regimens 2.
- The prognosis and therapeutic approaches for NHL and HL also differ, with the presence of Reed-Sternberg-like cells in NHL posing a diagnostic challenge due to their similarity to classical Reed-Sternberg cells in HL 4, 5.
- Molecular and cellular genetics play a crucial role in the diagnosis and prognosis of NHL, with advances in these fields leading to a better understanding of lymphomagenesis and the development of targeted therapies 6.