Index
- What is Hodgkin’s disease?
- What are the symptoms?
- Causes of Hodgkin’s disease or why does it occur?
- Can it be prevented?
- What is the treatment?
What is Hodgkin’s disease?
Hodgkin’s disease or Hodgkin’s lymphoma is a type of lymphoma; that is, a cancer that originates in the white blood cells or lymphocytes (defense cells of the immune system). It is a cancer of the lymphatic system, which is a network of organs, lymph nodes, lymph ducts and vessels that produce lymph and transport it from the tissues to the bloodstream. It is essential to the immune system.
In Hodgkin’s lymphoma, atypical lymphoid cells, called Reed-Sternberg cells, form uncontrollably, causing enlargement of the lymph nodes in a particular area, progressively spreading to other nearby lymph node areas, the spleen or the bone marrow. Although it can originate almost anywhere, it usually appears in the lymph nodes of the upper body: chest, neck and armpits.
The incidence in Spain is 30 new cases per million inhabitants per year. It affects both young people and those over 55 years of age. If it affects young people, it is more frequent among women and, if it affects older people, mostly men. Less frequently it affects children, accounting for 5% of childhood cancers.
According to the World Health Organization (WHO) it can be divided into two main types:
- Classical Hodgkin’s lymphoma. It is the most common (80% of cases), distinguishing four varieties, according to the accompanying cellular deficiency:
- Classic lymphocyte-rich Hodgkin’s lymphoma (10%).
- Hodgkin’s lymphoma with nodular sclerosis. It is the most frequent (55%), mainly affecting adolescents and young adults.
- Hodgkin’s lymphoma with mixed cellular sclerosis (16%).
- Hodgkin’s lymphoma with lymphocytic depletion. Common in patients with human immunodeficiency virus (HIV) (1%).
- Nodular lymphocytic predominance (20%).
This is how the lymphocytes in Hodgkin’s disease appear,
seen under a microscope
What are the symptoms?
60-70% of patients are asymptomatic, and are only diagnosed when an adenopathy is detected (palpable lymph node due to an increase in size). Thus, what the patient notices is a painless swelling of a lymph node, normally in the lateral area of the neck or around the clavicles, although it can also occur in the armpits or groin. Sometimes there is discomfort in the abdomen, which is related to an inflammation of the spleen, or symptoms related to compression of some structure, such as dry cough or pain in the lower back.
On the other hand, patients with symptoms may present:
- Night fever.
- Profuse sweating.
- Unexplained weight loss.
- Generalized itching.
- Pain from swollen lymph nodes.
Causes of Hodgkin’s disease or why it occurs
The causes of Hodgkin’s disease are currently unknown. However, an Epstein-Barr virus-related infection, such as mononucleosis, is thought to contribute to Hodgkin’s disease in certain cases. Also, people with HIV are at higher risk than the general population.
Is it preventable?
Of the known risk factors for Hodgkin’s disease, only a few can be changed, so the disease cannot be prevented in the vast majority of cases.
HIV does increase the risk, so the recommendations will be the same as for avoiding HIV infection.
Another risk factor is infection by the Epstein-Barr virus, which causes mononucleosis, although there is no way to prevent it.
What is the treatment?
The treatment of Hodgkin’s disease varies according to the extent of the lymphoma, but is always based on chemotherapy, accompanied by radiotherapy on affected areas.
In addition, in patients considered at high risk or with a high risk of relapse, autologous transplantation of hematopoietic progenitors is indicated.
The prognosis will depend on the type of Hodgkin’s lymphoma, the extent and the patient’s response to treatment. With the exception of some adverse factors, the probability of cure is over 80%. However, despite the generally good prognosis, patients do not achieve complete remission, and patients with late relapses have a worse prognosis.