Hodgkin's lymphoma

Hodgkin's lymphoma (HL) most commonly presents with painless cervical and/or supraclavicular lymphadenopathy in a young adult.

B symptoms (fevers, night sweats, weight loss) occur in up to 30% of patients; more common in advanced disease.

Imaging, preferably PET/CT, is essential to determine extent of disease. Biopsy is necessary to confirm diagnosis.

Combined-modality therapy (chemotherapy plus radiotherapy) is highly effective for early (stage I or stage II) classical HL, but it is associated with toxicity and long-term complications. PET-adapted treatment approaches for early-stage disease balance efficacy and safety through avoidance of radiotherapy in chemosensitive patients.

Chemotherapy is the cornerstone of treatment for advanced (stage III or stage IV) classical HL.

Radiotherapy is recommended for patients with early-stage nodular lymphocyte-predominant HL (NLPHL). Patients with advanced-stage NLPHL can be treated with rituximab plus chemotherapy. Observation may be appropriate for asymptomatic patients with early- or advanced-stage NLPHL.

Hodgkin's lymphoma (HL), also referred to as Hodgkin's disease, is an uncommon haematological malignancy arising from mature B cells. It is characterised by the presence of Hodgkin's cells and Reed-Sternberg cells.

The topic focuses on the diagnosis and management of adults with HL.