What’s the Difference Between Hodgkin and Non-Hodgkin Lymphoma?

There are three main types of blood cancers: lymphoma, leukemia, and myeloma.¹ Roughly half of the blood cancers diagnosed each year are lymphomas. Lymphoma is a type of blood cancer that attacks the lymphatic system—the lymph nodes in your neck, armpits, groin, and chest.

A healthy lymphatic system removes excess fluids from these areas and produces immune cells called lymphocytes. In lymphoma, the lymphocytes develop abnormally, and over time, these cancerous lymphocytes prevent the immune system from working properly.^1,2 There are two categories of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphoma, with non-Hodgkin being the most prevalent of the two. In fact, only 12% of patients with lymphoma have Hodgkin lymphoma.² Still, it is important to understand the difference between the two.

Hodgkin versus non-Hodgkin lymphoma

Both forms of lymphoma are relatively rare, and populations affected by the diseases vary. Though it can affect people of all ages, the average age of patients with non-Hodgkin lymphoma is 60. Hodgkin lymphoma most often occurs in younger patients between 15 and 24, or older patients over 60.³

Despite the fact that Hodgkin and non-Hodgkin lymphomas both affect the lymphatic system, there are quite a few differences between the two diseases. With the more-rare Hodgkin lymphoma, there is the presence of Reed-Sternberg cells—these are mature B cells that are unusually large, have become cancerous, and carry more than one nucleus, or core. Early symptoms of disease typically include the swollen lymph nodes in the upper area of the body, such as the neck, underarms, or chest.

With non-Hodgkin lymphoma, the presence of both out-of-control B cells or T cells can occur in the lymph nodes throughout the body, as well as other organs. Symptoms can include swelling in lymph nodes in multiple areas of the body. There are more than 60 different types of non-Hodgkin lymphoma.³

B cells and T cells affect the immune system differently. Both cell types work by attacking invading organisms. However, B cells fight bacteria and viruses by producing antibodies which serve to destroy infected cells. Whereas T cells can both produce antibodies to attack infected cells and directly attack and kill infected cells.⁴ In both cases of lymphoma, the T and/or B cells develop abnormally and no longer serve as fighters for the immune system.²

Diagnosis also tends to differ between the two types of lymphoma. With Hodgkin lymphoma, progression occurs slowly, beginning with one group of lymph nodes before moving to the next. Therefore, it is often diagnosed before it reaches an advanced stage. With non-Hodgkin lymphoma, it is often more advanced at the time of detection.³

Symptoms

Symptoms for both types of lymphoma are similar and can include:²

• Swollen lymph nodes in the neck, armpits, or groin
• Fever
• Weakness and fatigue
• Weight loss
• Sweating
• Difficulty breathing and/or chest pain
• Itchy skin
• Rash

Treatment

Treatment for both Hodgkin and non-Hodgkin lymphomas varies, and can depend on several factors such as type of disease, how aggressive it is or the disease stage, the location of disease, and the age and health of the patient.³ Treatment options might include:²

• Chemotherapy
• Chemotherapy and radiation directly targeting the lymphoma(s)
• Biological therapy, such as directing antibodies at lymphoma cells
• Stem cell transplant

What are the prognoses for Hodgkin and non-Hodgkin lymphoma?

Hodgkin lymphoma is one of the most successfully treated cancers. Ninety percent of patients survive over 5 years after diagnosis. Non-Hodgkin lymphoma has a lower rate of survival, but for certain types, recovery rates can be close to those of Hodgkin lymphoma patients. New treatment options continue to emerge, and the use of targeted immunotherapy shows promise.³