Hodgkin Lymphoma

What is Hodgkin lymphoma?

Hodgkin lymphoma is a cancer that starts in the lymph system (part of the immune system) and causes affected lymph nodes to get larger. This cancer may spread to the spleen, liver, bone marrow or lungs.

Children are more likely to develop Hodgkin lymphoma if they:

• have been infected with the Epstein-Barr virus or had mononucleosis (“mono,” caused by this virus);
• have been infected with HIV (human immunodeficiency virus);
• have a weakened immune system, either from an inherited disease or from medication to suppress the immune system after an organ or bone marrow transplant; or
• have a close relative, especially a brother or sister, who also has or had Hodgkin lymphoma.

How common is Hodgkin lymphoma?

• In the United States, 6,000 to 7,000 new cases of Hodgkin lymphoma are diagnosed each year.
• Children younger than age 5 rarely develop Hodgkin lymphoma. The likelihood of developing it increases as children grow older, peaking in young adulthood and later in older adults.
• Hodgkin lymphoma is more common in boys than in girls.

What are the symptoms of Hodgkin lymphoma?

If your child has Hodgkin lymphoma, the following symptoms may be present:

• Swollen (but not sore) lymph nodes in the neck, chest, armpit or groin
• Extreme fatigue
• Loss of appetite
• Weight loss
• Fever
• Night sweats
• Itchy skin

How is Hodgkin lymphoma treated?

• Chemotherapy (“chemo”)—uses powerful medicines to kill cancer cells or stop them from growing (dividing) and making more cancer cells:
  • Chemo may be injected into the bloodstream, so that it can travel throughout the body.
  • Some chemo may be given by mouth.
  • Combination therapy uses more than one type of chemo at a time.

• Chemotherapy alone or combined chemotherapy and low-dose radiation therapy are the standard treatments for young patients and those who have more advanced disease. Depending on the type of Hodgkin lymphoma and the extent of its spread, surgery may be done first to remove as much of the tumor as possible.

• Radiation therapy—uses high-energy X-rays or other types of radiation to kill cancer cells or stop them from growing.

• Radiation therapy works well for Hodgkin lymphoma that has not spread. However, radiation therapy may disrupt the growth of bones and soft tissues in young children. It may also increase the risk of heart disease and second cancers as patients grow older. Radiation is being used less for treating children with Hodgkin lymphoma.

• Targeted therapy—uses medicines or other treatments that target and attack specific cancer cells without harming normal cells. The most recent St. Jude clinical trial includes this kind of approach.

What are the survival rates for Hodgkin lymphoma?

In general, five-year survival rates for Hodgkin lymphoma are very good:

• Between 90 and 95 percent for those with early diagnoses.
• About 90 percent for children whose disease has spread.

Why choose St. Jude for your child’s Hodgkin lymphoma treatment?

• St. Jude is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children.
• St. Jude has created more clinical trials for cancer than any other children’s hospital in the United States.
• The nurse-to-patient ratio at St. Jude is unmatched—averaging 1:3 in hematology and oncology, and 1:1 in the Intensive Care Unit.
• Patients have access to a multidisciplinary team sub-specialized in Hodgkin lymphoma and non-Hodgkin lymphoma.
• Newer risk-adapted therapies are being studied to see if it is possible to reduce the amount of treatment and still maintain cure rates. Reducing treatment should reduce the long-term side effects of heart and lung disease and second cancers. Three treatment protocols are currently available at St. Jude for patients with Hodgkin lymphoma: HOD99, HOD05 and HOD08.
• St. Jude is headquarters to the Pediatric Hodgkin Lymphoma Consortium, a multi-center effort to develop novel treatment strategies for children with Hodgkin lymphoma. The consortium is led by St. Jude and includes Stanford University School of Medicine and Lucile Packard Children’s Hospital at Stanford; Dana-Farber Cancer Institute and Boston Children’s Hospital; Massachusetts General Hospital; and Maine Medical Center.
• Long-term side effects in survivors of Hodgkin lymphoma are being investigated in the St. Jude LIFE studies.
• Laboratory-based scientists are working with doctors to better understand the role that viruses like the Epstein-Barr virus play in how Hodgkin lymphoma develops. This information will be helpful in developing new approaches to treat Hodgkin lymphoma.