Patient Education: Hodgkin Lymphoma
by Mackenzie Gignac
Hodgkin Lymphoma is one of the more rare types of Lymphomas. To learn more about this form of blood cancer we chatted with Associate Professor Ali Bazargan who is a specialist in treating blood cancers.
What is Hodgkin Lymphoma?
Hodgkin Lymphoma is a type of blood cancer that starts in the white blood cells called lymphocytes. HL will begin to grow at one lymph node and spread to other places in the body.
Often the first sign of Hodgkin Lymphoma is found in the neck says A/Prof Bazargan. This form of lymphoma can disperse from one group of lymph nodes to another via the lymphatic system. Additionally, it can spread to other lymph tissues such as the spleen and bone marrow. Because of this sometimes Hodgkin Lymphoma appears in several parts of the body at the same time. It can even spread outside the lymphatic system to form a tumour in other organs, such as the liver or lung. These cases are known as extranodal disease.
Is Hodgkin Lymphoma Curable?
There is good news for those that receive a Hodgkins Lymphoma diagnosis. This type of cancer is curable in more than 75 percent of patients says A/Prof Bazargan. However, there can be therapy-related complications. Sometimes second cancers and cardiovascular disease can cause morbidity and mortality among Hodgkin Lymphoma survivors. These issues might not be apparent until some years after treatment.
How will Hodgkin Lymphoma impact my life?
There are some impacts that patients should be aware of in regards to Hodgkin Lymphoma. Hodgkin Lymphoma and the treatment options can lead to significant fatigue, a low immune system and complicating other medical and psychological issues.
A/Prof Bazargan advises making lifestyle changes that might not directly affect the cancer itself but can play an important role in one’s overall physical and mental health. His recommended guidelines include:
- Quitting smoking
- Reduce risk of infection
- Make dietary changes
- Exercise regularly
- Manage fatigue
- Seek medical or psychological support
These actions can lead to health benefits such as:
- To help to manage or lessen the side effects of treatment
- Keeps your immune system strong to aid in the fight against Hodgkin Lymphoma or other illnesses
- Improves emotional outlook throughout diagnosis and treatment for Hodgkin Lymphoma
- Decreases the risk of other medical problems that could complicate your health
Another way in which Hodgkin Lymphoma diagnosis might impact your life is through the side effects of chemotherapy treatment. Ali mentions, ‘common side effects of selected chemotherapies include infections, a drop in blood count, anaemia (lack of red blood cells), neutropenia (low white cell count), a drop in platelet counts, hair loss, mouth ulcers, skin rash and diarrhea.
Further, there are some specific side effects that can come of chemotherapy treatment which include: lung toxicity, nerve damage (peripheral neuropathy) which cause pins and needles and numbness in the hands and feet.
What does treatment look like for Hodgkin Lymphoma? How long does treatment take?
The choice of treatment for Hodgkin Lymphoma is determined depending on stage of the disease and prognostic factors. Hodgkin Lymphoma is grouped into three different stages
- Early-stage favourable risk
- Early-stage unfavourable risk group
- Advanced stage Hodgkin Lymphoma
For early-stage favourable risk group treatment will include 2-3 limited cycles of chemotherapy followed by radiation therapy to the field.
For the advanced stage Hodgkin Lymphoma there are two common types of chemotherapy used: ABVD or Escalated BEACOPP which provide a complete remission rate of 80-90 percent.
Both options are comprised of various chemotherapy drugs that combine to provide a synergistic impact on the cancer.
For patients that have relapsed with Hodgkin Lymphoma there are some clinical trial options that use different drugs besides your traditional chemotherapy drug agents.
What are the clinical trial options for Hodgkin Lymphoma?
A/Prof Bazargan says that some clinical trial options now are working to improve the current chemotherapy treatment. ‘Our clinical trials are focused on adding novel agents to the chemotherapy backbone to improve the outcome for patients with newly diagnosed Hodgkin Lymphoma,’ he said.
One of the most recent advances to aid the current chemotherapy treatment is CART therapy. ‘Recent data on CART cell therapy for relapsed Hodgkin Lymphoma has been promising,’ he said. ‘We should see initiation of those successful trials in the near future in Australia.’
Doctors are aware of the long term effects that patients suffer from traditional chemotherapy which can include increased cardiovascular risks, secondary malignancies, infertility, thyroid issues and psychosocial issues.
However, there is progress that is being made on the medical front to reduce these issues through clinical trials. A/Prof Bazargan mentions, ‘further trails are being focused on omitting some of the chemotherapy drugs in order to reduce toxicities, but without impacting the efficacy of planned treatment.’
‘We have seen a number of new treatment options including Brentuximab Vedotin and Pembrolizumab which are currently available through Medicare for relapsed Hodgkin Lymphoma,’ he said. ‘These therapies have changed the horizon for treatment of Hodgkin Lymphoma.’
What Causes Hodgkin Lymphoma?
Hodgkin Lymphoma is caused by a mutation in the DNA of B Lymphocytes which are a type of white blood cells. However, the exact reason for this is not known.
A/Prof Bazargan says that HL isn’t infectious and is also not thought to run in families unless you have a first-degree relative has had lymphoma. In this case your chances are increased, but it is not clear if this is because of inherited genetics or lifestyle factors.
Hodgkin Lymphoma can occur at any age, however most cases are diagnosed in people who are in their early 20s or 70s and it is slightly more common in men than women.
For any patients looking for a second opinion or to talk with a doctor about their recent diagnosis reach out to our team of blood specialists today. Appointments can be scheduled through our office with a doctor’s referral.