With a common origin, similar symptoms, and a common name, it is easy to confuse Hodgkin’s lymphoma with non-Hodgkin’s lymphoma. Both types of cancers begin in the lymphatic system, which is the body’s network of lymph nodes that sends white blood cells called B lymphocytes, and these cells produce antibodies that help us fight infection. Patients with any type of cancer may experience extreme fatigue, weight loss, appetite, fever, sweating, and other common symptoms. Both are named after Dr. Thomas Hodgkin, the pioneering researcher who recorded the symptoms of the diseases. But there are important differences between the two.
The main diagnostic difference between non-Hodgkin’s lymphoma and non-Hodgkin’s lymphoma can be determined during a biopsy, usually from the affected lymph node. If the pathologist detects Reed-Sternberg cells in the biopsy, the patient is diagnosed with Hodgkin’s lymphoma. Reed-Sternberg cells, named after the two scientists who first identified them under the microscope, are massive mutant B cells by cytological standards, five times larger than normal lymphocytes. A common variety of these cells contains at least two nuclei that give them the appearance of owl eyes. Another type is called a popcorn cell because of its lobular shape. The different shapes of Reed-Sternberg cells can help pathologists identify the specific type of Hodgkin lymphoma.
There are many other differences that distinguish the two diseases. For example:
|Hodgkin lymphoma||Non-Hodgkin’s Lymphoma|
|32% of patients diagnosed with Hodgkin lymphoma are between 20 and 34 years old. The average age of a patient with the disease is 39 years.||Seventy-five percent of patients diagnosed with Hodgkin lymphoma are 55 years of age or older. The average age of a patient with the disease is 66 years.|
|Hodgkin lymphoma is rare, accounting for about 0.5 percent of all newly diagnosed cancers. An estimated 8,500 cases were diagnosed in 2016.||Non-Hodgkin’s lymphoma is the seventh most frequently diagnosed cancer, with an estimated incidence in 2016 of 72,500 cases.|
|More than 86 percent of patients diagnosed with Hodgkin lymphoma live for five years or more.||About 70 percent of people diagnosed with non-Hodgkin’s lymphoma survive five years or more.|
|There are six types of Hodgkin lymphoma. The most common forms are classical nodular sclerosis Hodgkin lymphoma and classical mixed cell Hodgkin lymphoma. They account for about 90 percent of all cases.||There are more than 61 types and subtypes of non-Hodgkin’s lymphoma. B-cell lymphomas account for 85 percent of all cases. Diffuse large B-cell lymphoma is the most common form of non-Hodgkin’s lymphoma.|
Sources: National Cancer Institute and Lymphoma Research Foundation
Hodgkin, a British pathologist, first described some symptoms of the disease in a landmark 1832 article detailing postmortem examinations of various patients with enlarged lymph nodes and spleen. Thirty years later, another British physician, Dr. Samuel Wilkes, learned of Hodgkin’s work while conducting similar research. This condition was called Hodgkin’s disease. Since then, the disease has lost ownership and is called Hodgkin’s disease or Hodgkin’s lymphoma. Decades after Hodgkin’s discoveries, researchers were better able to recognize that lymphomas can be classified into two different types: Hodgkin’s and a similar but significantly different type, not Hodgkin’s.
Both diseases can be treated with chemotherapy, radiotherapy, and/or stem cell transplantation. Targeted therapy drugs such as ibritumomab tiuxetan (Zevalin® ) or rituximab (Rituxan® ) combined with radiotherapy or chemotherapy to treat non-Hodgkin’s lymphoma. Nivolumab (Opdivo ® ), an immunotherapy drug known as a checkpoint inhibitor, is approved to treat Hodgkin lymphoma. In December 2016, the US Food and Drug Administration granted a priority review of the checkpoint inhibitor pembrolizumab (Keytruda®) .) for the treatment of Hodgkin lymphoma. Multiple clinical trials are underway to determine whether immunotherapy drugs can also help treat non-Hodgkin’s lymphoma and other hematological malignancies, such as multiple myeloma. “Early data suggests that immunotherapy will play a role in the management of lymphomas in the future,” says Dr. Murray Markman, chief of medicine and sciences at Cancer Treatment Centers of America. ® (CTCA).