Classic Hodgkin lymphoma

Classic Hodgkin lymphoma (cHL), also known as classical Hodgkin disease, is a type of cancer that originates in the lymphatic system, which is part of the body's immune defense network. It is characterized by the presence of distinctive malignant cells called Reed-Sternberg cells, which are large, abnormal B-lymphocytes surrounded by a reactive inflammatory cell infiltrate. Classic Hodgkin lymphoma accounts for approximately 95% of all Hodgkin lymphoma cases and is subdivided into four histological subtypes: nodular sclerosis (the most common), mixed cellularity, lymphocyte-rich, and lymphocyte-depleted. The disease primarily affects the lymph nodes, most commonly presenting as painless swelling of lymph nodes in the neck, chest, or armpit regions. It can also involve the spleen, liver, bone marrow, and other organs as it progresses. Key symptoms include unexplained fever, drenching night sweats, unintentional weight loss (collectively known as 'B symptoms'), persistent fatigue, and pruritus (itching). Some patients experience pain at affected lymph node sites after consuming alcohol, which is a distinctive but uncommon feature. The disease has a bimodal age distribution, with peaks in young adults (ages 15–35) and in older adults (over age 55). Epstein-Barr virus (EBV) infection has been associated with a subset of cases. Classic Hodgkin lymphoma is considered one of the most curable forms of cancer. Treatment typically involves combination chemotherapy regimens such as ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) or escalated BEACOPP, often combined with radiation therapy depending on disease stage. For relapsed or refractory disease, high-dose chemotherapy followed by autologous stem cell transplantation is a standard approach. Newer targeted therapies, including the antibody-drug conjugate brentuximab vedotin and immune checkpoint inhibitors such as nivolumab and pembrolizumab, have significantly improved outcomes for patients with difficult-to-treat disease. Overall cure rates exceed 80%, with early-stage disease having particularly favorable prognosis.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Classic Hodgkin lymphoma