This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science.
This page was updated on May 26, 2022.
Hodgkin lymphoma treatment generally depends on the stage of disease, the patient's overall health and other factors. The patient's individualized treatment plan often includes a combination of medical treatments and technologies, along with supportive care services to help manage side effects, build strength and maintain quality of life.
The primary treatments for Hodgkin lymphoma include those listed below.
Combination chemotherapy is typically the most common treatment for Hodgkin lymphoma. This often consists of taking several drugs together in a set regimen. Depending on the regimen, Hodgkin lymphoma chemotherapy treatments may be administered in pill form, as an injection or intravenously. The patient may receive chemotherapy alone, or in combination with radiation therapy, targeted therapy, immunotherapy and/or stem cell transplantation.
Because each medication destroys tumor cells in a different way, a combination of drugs may make the cells more responsive to treatment.
While chemotherapy destroys rapidly-dividing cancer cells, it may also affect healthy cells, such as those in the hair, mouth, GI tract and bone marrow.
Sometimes, chemotherapy temporarily lowers the patient's blood counts, causing:
Other side effects of chemotherapy for Hodgkin lymphoma may include nausea and vomiting, diarrhea, hair loss, mouth sores, fertility problems, shortness of breath and heart damage.
Throughout the patient's Hodgkin lymphoma treatment, the care team may recommend a combination of supportive care services to prevent or manage chemotherapy-related side effects. The care team may prescribe certain drugs before treatment to combat nausea or prevent infection.
A stem cell transplant, also referred to as a bone marrow transplant, may be an option for patients with Hodgkin lymphoma that recurs (comes back) or is refractory (unresponsive to primary treatment).
Before a stem cell transplant, the patient will undergo a conditioning regimen, which involves intensive treatment, such as high-dose chemotherapy, to destroy as many cancer cells as possible. Then, the patient will receive the stem cells intravenously (similar to a blood transfusion). The procedure takes about an hour. After entering the bloodstream, the stem cells travel to the bone marrow and begin to produce healthy new blood cells in a process known as engraftment.
Sometimes, the high doses of chemotherapy or radiation the patient receives before the stem cell transplant causes side effects, such as infection. An allogeneic stem cell transplant poses the risk of graft-versus-host-disease (GVHD), a condition where the donated cells attack the patient’s tissues. The care team may prescribe certain drugs to reduce the risk of infection or GVHD.
Recovery from stem cell transplantation may take several months. The patient may need supportive care, such as pain management, nutritional counseling or naturopathic support to help manage side effects and maintain his or her quality of life.
Radiation therapy may be used to destroy lymphoma cells, to prevent the cells from spreading, and/or to relieve pain or discomfort caused by an enlarged spleen or swollen lymph nodes. For Hodgkin lymphoma patients, radiation treatments are commonly directed at lymph nodes in the neck, chest, underarms, abdomen, spleen, pelvis and/or groin.
The care team may combine radiation with other Hodgkin lymphoma treatments, like chemotherapy, to prevent the growth of new cancer cells.
Depending on where in the body the radiation is directed, along with other factors, radiation therapy for Hodgkin lymphoma may cause certain side effects. It may lower white blood cell count, which increases the risk of infection. Other potential side effects include fatigue, nausea, dry mouth, skin reactions and fertility problems (from radiation to the pelvic area).
As the patient receives treatment for Hodgkin lymphoma, the care team helps manage these radiation-induced side effects. The team will monitor the patient's blood counts regularly. If needed, the patient will receive therapies to stimulate blood cell production and prevent or treat infection.
The patient will also have access to supportive care services like nutrition therapy, naturopathic support, pain management, oncology rehabilitation and mind-body medicine. These therapies are designed to help keep the patient strong enough to continue treatment while participating in everyday activities.
Immunotherapy drugs and treatments are designed to help stimulate the immune system or to help immune cells better identify and attack cancer cells. Checkpoint inhibitor drugs work by blocking signals cancer cells use to hide from the immune system. A checkpoint inhibitor may be used to treat some patients with classical Hodgkin lymphoma (cHl) whose previous treatment did not work or who have relapsed after receiving three or more types of treatment.
Because immunotherapy treatments may also cause the immune system to attack healthy cells in addition to cancer cells, they may cause side effects. Immunotherapy side effects may include flu-like symptoms, fatigue, skin rashes and gastrointestinal problems.
Targeted therapy drugs attach themselves to specific protein receptors in or on the surface of cancer cells, which may allow them to cause less damage to healthy cells than chemotherapy and radiation.
Monoclonal antibody therapy is a type of targeted therapy that may be used to treat Hodgkin lymphoma. These medications are created by engineering antibodies in a laboratory, and then injecting them into the body to target specific proteins found on cancer cells. Once the antibodies find the cancer cells, they aim to destroy them, stop them from growing or halt spreading.
Depending on the patient’s health and the type of Hodgkin lymphoma, the care team may discuss other options with the patient, such as those listed below.
Watchful waiting or active surveillance for some patients with nodular-lymphocyte predominant Hodgkin lymphoma.
Steroid therapy or watchful waiting may be an option for pregnant patients with Hodgkin lymphoma.
Clinical trials may be available for some patients. The care team may share information about available clinical trials that are evaluating potential new therapies for Hodgkin lymphoma.
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