What is Hodgkin's Disease?
There are 2 main types of lymphoma: Hodgkin's lymphoma (or Hodgkin's disease) and non-Hodgkin's lymphoma. They differ in the cells that form these types of cancer. Over 55,000 Americans will be diagnosed with non-Hodgkin's lymphoma this year, compared to just over 7,000 with Hodgkin's disease.
Hodgkin's disease, also called Hodgkin's lymphoma, is a type of cancer that begins in lymphatic tissue. Lymphatic tissue includes the lymph nodes and other parts of the body's immune and blood-forming systems. Hodgkin's disease affects white blood cells, which help the body fight disease. Lymph nodes are small, bean-shaped organs found underneath the skin in the neck, underarm and groin. They may also be found inside the chest, abdomen and pelvis.
Treatment for Hodgkin's Disease
Hodgkin's disease is generally treated using chemotherapy, radiation therapy or a combination of both. The role of each depends on the stage, or extent, of disease. Surgery may be used to diagnose the disease, but rarely to remove the diseased organs. Nodular lymphocyte-predominant Hodgkin's lymphoma may be treated, if it is localized, using involved-field radiotherapy (where radiation targets only the diseased area while sparing nearby healthy tissue).
Through national clinical trials, doctors at Philadelphia's Fox Chase Cancer Center offer the latest treatment options, such as targeting lymphoma cells with highly specific monoclonal antibodies, and high-dose chemotherapy with bone-marrow transplantation. Monoclonal antibodies are types of proteins made in the laboratory that can be used alone or to carry drugs or other agents directly to a tumor. Immunotherapy (monoclonal antibody therapy and vaccine therapy) is also being studied at Fox Chase Cancer Center to determine its effectiveness in treating Hodgkin's disease.
Early Stage Hodgkin's Disease
For patients with early stage Hodgkin's disease, Fox Chase Cancer Center doctors may offer a shorter course of less toxic chemotherapy, such as ABVD (doxorubicin—formerly called adriamycin, bleomycin, vinblastine and dacarbazine), plus a smaller field of radiation therapy than has been typically used.
Advanced Hodgkin's Disease
Patients with advanced Hodgkin's disease usually receive a combination of chemotherapy agents (ABVD or Stanford V, an intensive, short-course, 7-drug regimen). Radiation therapy may follow treatment with Stanford V.
Treatment for patients with disease that recurs (comes back) depends on the patient's initial treatment and the new location of the disease. For those whose disease recurs after radiation therapy, treatment with standard-dose chemotherapy may be successful. When recurrence happens following initial treatment with chemotherapy, treatment may include stem cell transplant.
High-Dose Chemotherapy and Radiation Therapy with Stem Cell Transplant
Through clinical studies being performed at Fox Chase, patients are able to receive high doses of chemotherapy and radiation therapy while replacing blood-forming cells that are destroyed during treatment. Immature blood cells (otherwise known as stem cells) are removed from the blood or bone marrow of the patient to be frozen and stored. Following therapy, the stored stem cells are given back to the patient. These reinfused stem cells grow into (and restore) the body's blood cells, which makes recovery more successful.
Stem Cell Transplant
Doctors at Fox Chase Cancer Center offer treatments that include peripheral blood stem cell transplant, which has become life-saving therapy for some patients.
There are 2 common types of stem cell transplant:
- Autologous Stem Cell Transplant allows for a more aggressive treatment of certain cancers, including non-Hodgkin's lymphoma. In an autologous stem cell transplant, you are your own donor. Your bone marrow or peripheral blood stem cells (stem cells from the bloodstream) are taken from you (harvested), frozen until needed, then given back to you (transplanted) after you have received high doses of chemotherapy, radiation therapy or both, to destroy your cancer cells.
- Allogeneic Stem Cell Transplant is when your bone marrow and immune system are replaced with new, healthy bone marrow or peripheral blood stem cells from another person. Traditionally, most of the allogeneic stem cell transplants have been performed using stem cells collected from the bone marrow, but the use of peripheral blood stem cells in allogeneic stem cell transplants is rapidly increasing.
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