Hodgkin Lymphoma vs. Non-Hodgkin Lymphoma

Hodgkin lymphoma and non-Hodgkin lymphoma are both blood cancers that begin in lymphocytes. Lymphocytes are white blood cells within the immune system. Though the two blood cancers bear slightly similar names, the two differ.

Hodgkin lymphoma has Reed-Sternberg cells, while non-Hodgkin lymphoma does not. They also differ based on how they are classified. Here's what you need to know about the two blood cancers, including causes, treatment, and living with either condition.

Difference Between Hodgkin vs. Non-Hodgkin Lymphoma

More than 90 lymphoma subtypes exist, but they can be put into two categories: Hodgkin lymphoma and non-Hodgkin lymphoma. The difference comes down to the presence or absence of a unique type of cell that can be viewed under a microscope and the subtypes of each cancer.

Reed-Sternberg Cells

People who have Hodgkin—aka Hodgkin's—lymphoma have a specific type of cancerous cells called Reed-Sternberg cells. People with non-Hodgkin (some people call it non-Hodgkin's) lymphoma do not have these cells.

The name is a nod to the scientists who first correctly illustrated and described Reed-Sternberg cells. They're much larger than other lymphocytes and contain more than one nucleus, the spot that contains most of a cell's genetic material.

Type Classification

The blood cancers are also different in their classifications. For example, Hodgkin lymphoma can present as classic or nodular lymphocyte-predominant. The classic type of the condition has the "standard" Reed-Sternberg cells; the nodular lymphocyte-predominant type has popcorn cells, which are Reed-Sternberg cell variants. Non-Hodgkin lymphoma types include:

• Aggressive: The lymphoma quickly spreads and needs immediate treatment
• B lymphocyte: The lymphoma affects B cells, which make antibodies
• Indolent: The lymphoma slowly spreads and doesn't require immediate treatment
• T lymphocyte: The lymphoma affects T cells, which attack germs or regulate other immune system cell activity
  

Hodgkin vs. Non-Hodgkin Lymphoma: Symptoms

Lymphoma doesn't always cause noticeable symptoms, especially if it's not aggressive. However, either type of cancer might cause:

• Chest pain
  
• Chills or night sweats
• Cough or trouble breathing
• Fatigue
• Fever chills
• Lymph node swelling
• Shortness of breath
• Unintentional weight loss

Hodgkin lymphoma may also result in itching skin or appetite loss, but other symptoms specific to non-Hodgkin lymphoma can include:

• Early satiety after eating a small amount of food
• Easy bruising or bleeding
• Severe or frequent infections
• Swollen belly

Causes of Hodgkin vs. Non-Hodgkin Lymphoma

The causes of Hodgkin and non-Hodgkin lymphoma are unknown. However, a possible trigger for Hodgkin lymphoma is an Epstein-Barr virus infection that leads to B cell DNA changes.

Risk Factors

Anyone can get lymphoma, but a major risk factor is having a weakened immune system. Organ transplant recipients—who take anti-rejection medication—face an elevated risk, as do those who live with an autoimmune rheumatologic disease like rheumatoid arthritis or lupus, Gary Schiller, MD, professor of hematology/oncology and director of the UCLA Hematological Malignancies/Stem Cell Transplant Unit told Health. Other risk factors include:

• Age—in general, older for both cancers and younger for Hodgkin lymphoma
• Being assigned male at birth
• Family history of either cancer, though family links are uncommon for Hodgkin lymphoma
• Radiation exposure for non-Hodgkin lymphoma
  

Treatment for Hodgkin and Non-Hodgkin Lymphoma

Treatment will vary based on the type of lymphoma and how aggressive it is. However, possible treatments for either type of lymphoma are chemotherapy, radiation, or both.

Some people require a stem cell transplant. The transplant may involve harvesting and reinfusing your own blood stem cells (autologous transplant) or using donor stem cells (allogeneic transplant).

A healthcare provider might prescribe immunotherapy. Immunotherapy uses drugs that harness the power of your immune system. This treatment may be used if other treatments are unsuccessful.

Living With Hodgkin vs. Non-Hodgkin Lymphoma

While ridding your body of the cancer might seem like the point of treatment, that's not necessarily the case because some people can live with lymphoma for a long time. "The goal is not always a cure," said Dr. Schiller. "The goal is survival."

Generally speaking, Hodgkin lymphoma tends to be diagnosed earlier, so it can be easier to treat than non-Hodgkin lymphoma. More than 90% of people with Hodgkin lymphoma survive more than 5 years from the time of their diagnosis.

It's harder to make generalizations about non-Hodgkin lymphoma because there are more than 60 subtypes. Prognosis varies widely depending on the specific subtype and how aggressive the cancer is, among other factors.