Hodgkin’s vs Non-Hodgkin’s Lymphoma: Key Differences

In 2020 itself, 600,000 people were affected by lymphoma worldwide, and among them, 280,000 lost their lives. That’s almost the same as the entire population of Barbados!

Lymphoma comes in two variants: Hodgkin’s and Non-Hodgkin’s. This scary younger cousin of blood cancer basically attacks the lymph nodes in our body and then spreads like the plague. Countries like North America, Northern Europe, Australia and New Zealand suffer worse as these countries make up for most cases.

What makes it intriguing to talk about Lymphoma is that having a first-degree relative lymphoma doubles the chances of a person suffering from Lymphoma. So, it is not just the people who are suffering but also those who are closely related to them. The more you think about it, the scarier it appears.

While the names of these two diseases are similar, they are dramatically different. Both are cancers in our lymphocytes that can have a huge impact on the body and spread through the lymphatic system of the body.

Lymphocytes are an indispensable part of the germ-fighting immune system of our body. Once you look at the cancer cells under a microscope, the difference between Hodgkin’s and non-Hodgkin’s lymphoma becomes clear.

If you find a particular type of cell called the Reed-Sternberg cell, the lymphoma is called Hodgkin’s. If the Reed-Steinberg cell isn’t there, the lymphoma is non-Hodgkin’s. Simple, right?

Since there are many subtypes of lymphoma present, a lab test is done to examine the sample of your lymphoma cells to find the particular subtype. The type of lymphoma you have helps to narrow down your prognosis and treatment options.

The types of lymphoma have varied disease courses and treatment options. An accurate diagnosis is very important so you get the care that you need.

What are Reed-Sternberg cells?

One of the characteristics of these cells is that they are large and include multiple nuclei. Just like other cancer cells, these cells too multiply uncontrollably and collect in an abnormal way.

Reed-Sternberg cells come together in parts of the lymphatic system, especially the lymph nodes. As time passes, the accumulation of these abnormal lymphocytes can result in tumour growth and interfere with the ability of the body to fight back infection.

The Role of the Lymphatic System

Lymph refers to the watery fluid that is found in our body. It finds its way through the body thanks to an extensive network of tissues, vessels and organs also known as the lymphatic system. This fluid transports a bunch of vital substances, including lymphocytes and disease-fighting white blood cells that play an important role in the immune system of the body.

When cancer affects the lymphocytes, it is called lymphoma. The main difference between Hodgkin and non-Hodgkin lymphoma is the kind of lymphocyte that gets impacted.

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

Apart from the presence or lack of Reed-Sternberg cells, other differentiators between Hodgkin and non-Hodgkin lymphoma are

Non-Hodgkin lymphoma is more widespread than Hodgkin lymphoma, even though both variations of cancer are relatively rare. Most patients of non-Hodgkin lymphoma are over the age of 55 when they are first diagnosed. On the other hand, the median age for diagnosis of Hodgkin lymphoma is around 39.

Non-Hodgkin lymphoma originates in lymph nodes in different areas of the body, whereas Hodgkin lymphoma usually starts in the upper body, such as the chest, neck or armpits. The progress of Hodgkin lymphoma is usually way more predictable than non-Hodgkin lymphoma, making it easier to identify and treat.

Hodgkin’s lymphoma has a number of different symptoms. Some of these are apparent, like fever, itchiness, while some are not so apparent. Just like other cancers, like liver cancer, oral cancer and bladder cancer.

Swollen lymph nodes

Your lymph nodes swell up. You experience painless swelling in the armpit, neck, groin or chest. Swollen lymph nodes are the most common symptom of Hodgkin’s lymphoma.

Fever

You start to have a fever. It is an intense fever at a high temperature, which can be accompanied by chills.

Night sweats

If you have Hodgkin’s lymphoma, you experience sweating. This is not any normal sweating but excessive sweating that starts to happen at night.

Unexplained weight loss

With Hodgkin’s lymphoma, you experience sudden weight loss over a brief period of time, that happens without dieting or exercise changes.

Itchiness

Patients suffering from Hodgkin’s lymphoma will experience constant itching all over the body.

Fatigue

People suffering from Hodgkin’s lymphoma might experience constant physical or mental tiredness that does not get better with rest.

Shortness of Breath

If you are suffering from Hodgkin’s lymphoma, you tend to have issues with breathing, which might happen because there is a huge lymph node mass in the chest.

Cough or Wheezing

If you have been diagnosed with Hodgkin’s lymphoma, you might be affected by a constant cough, or you might feel breathless.

Loss of Appetite

People suffering from Hodgkin’s lymphoma have a decreased appetite. They don’t feel like eating anything.

Abdominal Pain or Indigestion

If you have been impacted by Hodgkin’s lymphoma and the abdomen is affected by enlarged lymph glands, you might experience abdominal pain or indigestion.

Non-Hodgkin’s lymphoma also exhibits symptoms. Some of these are quite obvious, while the rest aren’t.

Swollen Lymph Nodes

With non-Hodgkin’s lymphoma, you experience painless swelling in the neck, groin, armpit or other areas of the body.

Fever

Next time when you have a fever, maybe a cold is not going to be the only probable reason that will plague you.

Night sweats

With non-Hodgkin’s lymphoma, you have night sweats. This is not your regular sweating but intense sweating that soaks your clothes and bedding.

Weight loss

If you are suffering from non-Hodgkin’s lymphoma, you experience weight loss that is more than 10% of your body weight and happens over a time of six months.

Fatigue

Fatigue is an important symptom of non-Hodgkin’s lymphoma. You experience this fatigue day and night, and you feel as if you can’t do anything.

Skin rash

If you have been affected by non-Hodgkin’s lymphoma, you tend to experience itchy skin or a rash in the back, chest or stomach.

Pain

With non-Hodgkin’s lymphoma comes pain that you feel in the bones, chest or stomach.

Coughing

If you are suffering from non-Hodgkin’s lymphoma, you cough a lot and have issues breathing where you can’t seem to breathe normally.

Loss of Appetite

Patients of non-Hodgkin’s lymphoma experience a loss of appetite where they can’t seem to feel hungry no matter what.

Temperature Changes

This type of blood cancer causes temperatures that happen without any obvious cause.

If you have been diagnosed with Hodgkin’s lymphoma or non-Hodgkin’s lymphoma, you have to undergo treatment. The treatment for the two different kinds of lymphomas varies depending on the kind of cancer you have.

If you have been affected by Hodgkin’s lymphoma, you may be subject to chemotherapy, radiation therapy, immunotherapy, targeted therapy or a combination of these. The treatment plan depends on the type and stage of Hodgkin’s lymphoma and the health of the patient.

Chemotherapy

Chemotherapy refers to a kind of cancer treatment in which medicine is used for killing cancer cells. It may be administered in different ways, depending on the stage of cancer you currently are in.

If medical personnel think your cancer is curable, you will receive chemotherapy treatment through a drip straight into your vein (intravenous chemotherapy). If there is no cure, you will be given chemotherapy tablets to help with your symptoms.

Chemotherapy happens over a few months on an outpatient basis, which means no overnight hospital stays. However, there might be instances where the symptoms or side effects of treatment warrant a longer hospital stay.

Chemotherapy has its side effects; the most important one is bone marrow damage. This can impact the production of healthy blood cells and result in fatigue, breathlessness, vulnerability to infection, bleeding and bruising easily, nausea, diarrhoea, loss of appetite, tiredness, and hair loss.

Radiotherapy

This is often used to treat early-stage Hodgkin lymphoma, where the cancer hasn’t spread to other parts of the body. Treatment is administered in short daily sessions over many weeks. You don’t have to stay in the hospital between appointments.

While radiotherapy is painless, it comes with side effects. These depend on the part of your body receiving treatment. For example, treatment to your throat can result in a sore throat, while treatment to the head might result in hair loss. Other side effects of radiotherapy include fatigue, nausea and vomiting, dry mouth, and a loss of appetite.

If you have been diagnosed with non-Hodgkin's lymphoma, you will be administered medicines or radiation therapy. Medicines for this cancer treatment include sessions of chemotherapy with immunotherapy and targeted therapy.

Your lymphoma will dictate the treatments that your healthcare team chooses for you. The team will consider the types of cells involved and the rate of growth of your cancer.

If your lymphoma is growing slowly and doesn’t show symptoms, you might not require treatment right away. You might be called for checkups every few months. This will help the team gauge your condition to see whether the cancer grows.

Chemotherapy

This type of treatment treats cancer with powerful medicines. Many chemotherapy medicines are given intravenously or orally. For many types of non-Hodgkin’s lymphoma, chemotherapy is the initial treatment. It might be combined with targeted therapy.

Immunotherapy

Immunotherapy for cancer is a treatment that depends on medicines that assist the body’s immune system in destroying cancer cells. The immune system fights diseases by attacking microbes and other cells which should not be in the body.

Cancer cells survive this by hiding from the immune system. Immunotherapy helps the immune system fight and kill cancer cells. People suffering from particular types of non-Hodgkin lymphoma might have immunotherapy if other treatments have failed.

Targeted therapy

This therapy uses medicines that target specific chemicals in cancer cells. Blocking such chemicals causes cancer cells to die.

For non-Hodgkin lymphoma, targeted therapy might be used alone. However, it is often combined with chemotherapy. This might be your first treatment. If the lymphoma returns, it becomes your second treatment.

CAR-T cell therapy

Chimeric antigen receptor T cell therapy, also known as CAR-T cell therapy, teaches the immune system to fight non-Hodgkin lymphoma. This treatment starts by removing some white blood cells, including T-cells, from the blood.

These cells are then sent to a lab. In the lab, they are treated so that they make special receptors. These receptors help cells recognise markers on the surfaces of the lymphoma cells. The cells then return to the body, where they find and destroy non-Hodgkin lymphoma cells.

CAR-T cell therapy is an option for some types of B-cell non-Hodgkin lymphoma, used when other treatments have failed.

Bone Marrow Transplant

A bone marrow transplant, also known as a bone marrow stem cell transplant, involves replacing infected bone marrow with healthy bone marrow stem cells in the body. These cells replace cells affected by chemotherapy and other treatments.

People suffering from non-Hodgkin lymphoma might have a bone marrow transplant if other treatments haven’t worked.

Radiation therapy

This therapy treats cancer with powerful energy beams that might come from X-rays, protons or other sources. During this treatment, you lie flat on a table while a machine moves around you, directing radiation to precise points on the body.

For some types of non-Hodgkin lymphoma, radiation might be the only treatment you require. This is true if your lymphoma is in just a couple of spots and grows slowly.

People suffering from non-Hodgkin lymphoma might require radiation after chemotherapy to kill lymphoma cells that remain. Radiation can relieve cancer symptoms and improve your quality of life.

In conclusion, it doesn’t matter whether you have been diagnosed with Hodgkin’s or non-Hodgkin’s lymphoma. Cancer is cancer, and it is dangerous, no matter what. If you are in treatment for lymphoma, all you need to do is eat healthy so the therapy doesn’t impact you much. Do regular sessions so that once a few months have passed, you can be cancer-free!

FAQs

What is the difference between Hodgkin's lymphoma and non-Hodgkin's lymphoma?

The main difference between Hodgkin’s and non-Hodgkin’s lymphoma is the presence of Reed-Sternberg cells.

What are the common symptoms of Hodgkin's lymphoma and non-Hodgkin's lymphoma?

Common symptoms include swollen lymph nodes (often painless), fever, night sweats, weight loss, and fatigue.

What causes Hodgkin's and non-Hodgkin's lymphoma?

The exact cause is unknown, but certain factors can increase risk. For Hodgkin's lymphoma, it is more common in young adults (especially those in their 20s) and older adults (over 55).Non-Hodgkin's lymphoma can develop in people of any age but is more common in older adults.

How is Hodgkin's lymphoma diagnosed?

Diagnosis typically involves a physical exam, blood tests, and imaging tests like CT or PET scans.

Is there a cure for Hodgkin's lymphoma?

Yes, Hodgkin's lymphoma is one of the most treatable types of cancer, with high cure rates, especially when diagnosed early.