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Hodgkin lymphoma

Last edited: 4/14/2026

Overview

Hodgkin lymphoma (HL) is a distinct hematological malignancy of B-cell origin characterized by unique histopathological features, including Reed-Sternberg cells, and generally favorable prognosis 2. It encompasses several subtypes, including classic HL and nodular lymphocyte predominant HL 11.

Diagnosis

  • Key Histopathological Features: Presence of Reed-Sternberg cells 2.
  • Imaging Studies: CT scans, PET scans for staging 10.
  • Laboratory Tests: Blood counts, LDH levels, and B symptoms assessment 9.
  • Immunohistochemistry: CD30 expression for confirmation 27.
  • Consensus Diagnosis: Multi-pathologist review recommended for accuracy 32.

    • Management

  • First-Line Treatment: ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine) regimen 9.
  • Advanced-Stage Disease: Addition of radiotherapy post-chemotherapy 10.
  • Relapsed/Refractory Disease: Brentuximab vedotin (BV) as a targeted therapy 113.
  • Novel Therapies: Panobinostat monotherapy for refractory cases 21.
  • Immunotherapy: Bispecific antibody AFM13 in clinical trials 17.
  • Radiation Therapy: Debated role in early-stage disease; consider intensity-modulated radiation therapy (IMRT) 22.

    • Special Populations

  • Pediatric Patients: Higher risk of cognitive impairment and early death post-treatment 8.
  • HIV-Positive Patients: Advanced, extranodal disease with aggressive features; tailored antiretroviral therapy crucial 412.
  • Elderly Patients: Tailored treatment approaches considering comorbidities and frailty 9.

    • Key Recommendations

  • First-Line Therapy with ABVD: Recommended for advanced-stage classic Hodgkin lymphoma (Evidence: Strong 9).
  • Incorporate Brentuximab Vedotin for Relapse: Consider BV for patients with relapsed or refractory disease (Evidence: Moderate 113).
  • Radiation Therapy in Early-Stage Disease: Consider IMRT for localized disease, balancing efficacy and toxicity (Evidence: Moderate 22).
  • Monitor and Manage Late Effects: Regular follow-up for cognitive and cardiovascular health in pediatric survivors (Evidence: Moderate 8).
  • Tailored Management in HIV-Positive Patients: Integrate cART with HL treatment strategies (Evidence: Moderate 4).

    • References

    1 Tan F, Li Y, Xia H, Yin W. Signal mining and analysis of adverse events of Brentuximab Vedotin base on FAERS and JADER databases. PloS one 2025. link 2 Rossi C, Manson G, Marouf A, Cabannes-Hamy A, Nicolas-Virelizier E, Maerevoet M et al.. Classic Hodgkin Lymphoma: The LYSA pragmatic guidelines. European journal of cancer (Oxford, England : 1990) 2024. link 3 El Fakih R, Bajuaifer YS, Shah AY, Sulaiman R, Almohamady R, ELGohary G et al.. Paraneoplastic syndromes associated with classic Hodgkin lymphoma, a systematic literature review. Annals of hematology 2024. link 4 Souza AT, Andrade FR, Sarmento AC, Villarim CC, Araújo-Filho I, Medeiros KS. Clinical features in Hodgkin lymphoma patients living with human immunodeficiency virus: A meta-analysis in the antiretroviral therapy era. International journal of STD & AIDS 2024. link 5 Ke C, Chen M, Huang Y, Chen Y, Lin C, Huang P. Cardiac toxicity of brentuximab vedotin: a real-word disproportionality analysis of the FDA Adverse Event Reporting System (FAERS) database. Naunyn-Schmiedeberg's archives of pharmacology 2024. link 6 Arabloo J, Azari S, Gorji HA, Rezapour A, Alipour V, Ehsanzadeh SJ. Cost-effectiveness of brentuximab vedotin in Hodgkin lymphoma: a systematic review. European journal of clinical pharmacology 2023. link 7 Kim J, Leon ME, Schinasi LH, Baldi I, Lebailly P, Freeman LEB et al.. Exposure to pesticides and risk of Hodgkin lymphoma in an international consortium of agricultural cohorts (AGRICOH). Cancer causes & control : CCC 2023. link 8 . Survivors of Pediatric HL May Age More Quickly. Cancer discovery 2023. link 9 Follows GA, Barrington SF, Bhuller KS, Culligan DJ, Cutter DJ, Gallop-Evans E et al.. Guideline for the first-line management of Classical Hodgkin Lymphoma - A British Society for Haematology guideline. British journal of haematology 2022. link 10 Buglione M, Guerini AE, Filippi AR, Spiazzi L, Pasinetti N, Magli A et al.. A Systematic Review on Intensity Modulated Radiation Therapy for Mediastinal Hodgkin's Lymphoma. Critical reviews in oncology/hematology 2021. link 11 Hartmann S, Eichenauer DA. Nodular lymphocyte predominant Hodgkin lymphoma: pathology, clinical course and relation to T-cell/histiocyte rich large B-cell lymphoma. Pathology 2020. link 12 Ding J, Kumar AJ, Wilding E, Lee ST, Law JY. Multi-Organ Failure as the Initial Presentation of Lymphocyte-Depleted Hodgkin Lymphoma in Two Patients with Human Immunodeficiency Virus. Acta haematologica 2020. link 13 Advani RH. Updates in Treatment Strategies for Hodgkin Lymphoma. Journal of the National Comprehensive Cancer Network : JNCCN 2019. link 14 Peggs KS. Should all patients with Hodgkin lymphoma who relapse after autologous SCT be considered for allogeneic SCT?. Blood advances 2018. link 15 . You're the Flight Surgeon. Aerospace medicine and human performance 2018. link 16 Tommasi C, Pellegrino B, Quaini F, Musolino A. My best choice after a round trip from illness. Acta bio-medica : Atenei Parmensis 2017. link 17 Hutchings M. Targeted immunotherapy in Hodgkin lymphoma. Blood 2015. link 18 Morton LM. Triple jeopardy for Hodgkin lymphoma survivors?. Blood 2014. link 19 Morton LM, Freedman DM. Shedding light on UVR and Hodgkin lymphoma. Blood 2013. link 20 Hessissen L, Khtar R, Madani A, El Kababri M, Kili A, Harif M et al.. Improving the prognosis of pediatric Hodgkin lymphoma in developing countries: a Moroccan Society of Pediatric Hematology and Oncology study. Pediatric blood & cancer 2013. link 21 . Panobinostat shows efficacy in Hodgkin lymphoma. Cancer discovery 2012. link 22 Meyer RM, Hoppe RT. Point/counterpoint: early-stage Hodgkin lymphoma and the role of radiation therapy. Hematology. American Society of Hematology. Education Program 2012. link 23 Greaves P, Gribben JG. Lymphoid neoplasia. Laser-capturing the essence of Hodgkin lymphoma. Blood 2012. link 24 Karunanayake CP, Spinelli JJ, McLaughlin JR, Dosman JA, Pahwa P, McDuffie HH. Hodgkin lymphoma and pesticides exposure in men: a Canadian case-control study. Journal of agromedicine 2012. link 25 Burnelli R, Fabbri E, Guerrini G, Sperlì D, D'ambrosio A. Neurological presentation of Hodgkin lymphoma in the Italian Association of Pediatric Hematology and Oncology LH-2004 protocol. Leukemia & lymphoma 2011. link 26 Koreishi AF, Saenz AJ, Persky DO, Cui H, Moskowitz A, Moskowitz CH et al.. The role of cytotoxic and regulatory T cells in relapsed/refractory Hodgkin lymphoma. Applied immunohistochemistry & molecular morphology : AIMM 2010. link 27 Lau SK, Thomas P, Weiss LM. Immunohistochemical evaluation of CON6D/B5: a new CD30 monoclonal antibody. Applied immunohistochemistry & molecular morphology : AIMM 2010. link 28 Audouin J, Le Tourneau A, Molina T, Diebold J. Initial lesions of classical Hodgkin's lymphoma of the nodular sclerosis type. Arkhiv patologii 2006. link 29 Mittal P, Daga SR. Hodgkins lymphoma with HIV infection. Indian pediatrics 2006. link 30 Wojtukiewicz MZ, Sawicki Z, Dziecioł J. A rare localization of Hodgkin's disease in the breast--a case report. Roczniki Akademii Medycznej w Bialymstoku (1995) 2001. link 31 Lee KM, Spittle MF. Hodgkin's disease: a case of late relapse. Clinical oncology (Royal College of Radiologists (Great Britain)) 1993. link80098-6) 32 Georgii A, Fischer R, Hübner K, Schwarze EW, Bernhards J. Classification of Hodgkin's disease biopsies by a panel of four histopathologists. Report of 1,140 patients from the German National Trial. Leukemia & lymphoma 1993. link 33 Hung SJ, Jhung JW, Anagnostou AA. Recurrence of Hodgkin's disease 29 years later. Cancer 1988. link61:1<186::aid-cncr2820610131>3.0.co;2-1) 34 Sharma SK, Pande JN, Dawar R, Guleria JS. Hodgkin's disease with pulmonary involvement. Japanese journal of medicine 1986. link 35 Mandell GA. Resolution of Hodgkin's induced ivory vertebrae. Pediatric radiology 1978. link 36 Frost P, Shalhub S. Ichthyosiform scaling in association with lymphoma. Southern medical journal 1976. link 37 Garvin AJ, Spicer SS, Parmley RT, Munster AM. Immunohistochemical demonstration of IgG in Reed-Sternberg and other cells in Hodgkin's disease. The Journal of experimental medicine 1974. link

    Original source

    1. [1]
      Signal mining and analysis of adverse events of Brentuximab Vedotin base on FAERS and JADER databases. — Tan F, Li Y, Xia H, Yin W PloS one (2025)
    2. [2]
      Classic Hodgkin Lymphoma: The LYSA pragmatic guidelines. — Rossi C, Manson G, Marouf A, Cabannes-Hamy A, Nicolas-Virelizier E, Maerevoet M et al. European journal of cancer (Oxford, England : 1990) (2024)
    3. [3]
      Paraneoplastic syndromes associated with classic Hodgkin lymphoma, a systematic literature review. — El Fakih R, Bajuaifer YS, Shah AY, Sulaiman R, Almohamady R, ELGohary G et al. Annals of hematology (2024)
    4. [4]
      Clinical features in Hodgkin lymphoma patients living with human immunodeficiency virus: A meta-analysis in the antiretroviral therapy era. — Souza AT, Andrade FR, Sarmento AC, Villarim CC, Araújo-Filho I, Medeiros KS International journal of STD & AIDS (2024)
    5. [5]
      Cardiac toxicity of brentuximab vedotin: a real-word disproportionality analysis of the FDA Adverse Event Reporting System (FAERS) database. — Ke C, Chen M, Huang Y, Chen Y, Lin C, Huang P Naunyn-Schmiedeberg's archives of pharmacology (2024)
    6. [6]
      Cost-effectiveness of brentuximab vedotin in Hodgkin lymphoma: a systematic review. — Arabloo J, Azari S, Gorji HA, Rezapour A, Alipour V, Ehsanzadeh SJ European journal of clinical pharmacology (2023)
    7. [7]
      Exposure to pesticides and risk of Hodgkin lymphoma in an international consortium of agricultural cohorts (AGRICOH). — Kim J, Leon ME, Schinasi LH, Baldi I, Lebailly P, Freeman LEB et al. Cancer causes & control : CCC (2023)
    8. [8]
      Survivors of Pediatric HL May Age More Quickly. Cancer discovery (2023)
    9. [9]
      Guideline for the first-line management of Classical Hodgkin Lymphoma - A British Society for Haematology guideline. — Follows GA, Barrington SF, Bhuller KS, Culligan DJ, Cutter DJ, Gallop-Evans E et al. British journal of haematology (2022)
    10. [10]
      A Systematic Review on Intensity Modulated Radiation Therapy for Mediastinal Hodgkin's Lymphoma. — Buglione M, Guerini AE, Filippi AR, Spiazzi L, Pasinetti N, Magli A et al. Critical reviews in oncology/hematology (2021)
    11. [11]
      Nodular lymphocyte predominant Hodgkin lymphoma: pathology, clinical course and relation to T-cell/histiocyte rich large B-cell lymphoma. — Hartmann S, Eichenauer DA Pathology (2020)
    12. [12]
      Multi-Organ Failure as the Initial Presentation of Lymphocyte-Depleted Hodgkin Lymphoma in Two Patients with Human Immunodeficiency Virus. — Ding J, Kumar AJ, Wilding E, Lee ST, Law JY Acta haematologica (2020)
    13. [13]
      Updates in Treatment Strategies for Hodgkin Lymphoma. — Advani RH Journal of the National Comprehensive Cancer Network : JNCCN (2019)
    14. [14]
      Should all patients with Hodgkin lymphoma who relapse after autologous SCT be considered for allogeneic SCT? — Peggs KS Blood advances (2018)
    15. [15]
      You're the Flight Surgeon. Aerospace medicine and human performance (2018)
    16. [16]
      My best choice after a round trip from illness. — Tommasi C, Pellegrino B, Quaini F, Musolino A Acta bio-medica : Atenei Parmensis (2017)
    17. [17]
      Targeted immunotherapy in Hodgkin lymphoma. — Hutchings M Blood (2015)
    18. [18]
      Triple jeopardy for Hodgkin lymphoma survivors? — Morton LM Blood (2014)
    19. [19]
      Shedding light on UVR and Hodgkin lymphoma. — Morton LM, Freedman DM Blood (2013)
    20. [20]
      Improving the prognosis of pediatric Hodgkin lymphoma in developing countries: a Moroccan Society of Pediatric Hematology and Oncology study. — Hessissen L, Khtar R, Madani A, El Kababri M, Kili A, Harif M et al. Pediatric blood & cancer (2013)
    21. [21]
      Panobinostat shows efficacy in Hodgkin lymphoma. Cancer discovery (2012)
    22. [22]
      Point/counterpoint: early-stage Hodgkin lymphoma and the role of radiation therapy. — Meyer RM, Hoppe RT Hematology. American Society of Hematology. Education Program (2012)
    23. [23]
      Lymphoid neoplasia. Laser-capturing the essence of Hodgkin lymphoma. — Greaves P, Gribben JG Blood (2012)
    24. [24]
      Hodgkin lymphoma and pesticides exposure in men: a Canadian case-control study. — Karunanayake CP, Spinelli JJ, McLaughlin JR, Dosman JA, Pahwa P, McDuffie HH Journal of agromedicine (2012)
    25. [25]
      Neurological presentation of Hodgkin lymphoma in the Italian Association of Pediatric Hematology and Oncology LH-2004 protocol. — Burnelli R, Fabbri E, Guerrini G, Sperlì D, D'ambrosio A Leukemia & lymphoma (2011)
    26. [26]
      The role of cytotoxic and regulatory T cells in relapsed/refractory Hodgkin lymphoma. — Koreishi AF, Saenz AJ, Persky DO, Cui H, Moskowitz A, Moskowitz CH et al. Applied immunohistochemistry & molecular morphology : AIMM (2010)
    27. [27]
      Immunohistochemical evaluation of CON6D/B5: a new CD30 monoclonal antibody. — Lau SK, Thomas P, Weiss LM Applied immunohistochemistry & molecular morphology : AIMM (2010)
    28. [28]
      Initial lesions of classical Hodgkin's lymphoma of the nodular sclerosis type. — Audouin J, Le Tourneau A, Molina T, Diebold J Arkhiv patologii (2006)
    29. [29]
      Hodgkins lymphoma with HIV infection. — Mittal P, Daga SR Indian pediatrics (2006)
    30. [30]
      A rare localization of Hodgkin's disease in the breast--a case report. — Wojtukiewicz MZ, Sawicki Z, Dziecioł J Roczniki Akademii Medycznej w Bialymstoku (1995) (2001)
    31. [31]
      Hodgkin's disease: a case of late relapse. — Lee KM, Spittle MF Clinical oncology (Royal College of Radiologists (Great Britain)) (1993)
    32. [32]
      Classification of Hodgkin's disease biopsies by a panel of four histopathologists. Report of 1,140 patients from the German National Trial. — Georgii A, Fischer R, Hübner K, Schwarze EW, Bernhards J Leukemia & lymphoma (1993)
    33. [33]
      Recurrence of Hodgkin's disease 29 years later. — Hung SJ, Jhung JW, Anagnostou AA Cancer (1988)
    34. [34]
      Hodgkin's disease with pulmonary involvement. — Sharma SK, Pande JN, Dawar R, Guleria JS Japanese journal of medicine (1986)
    35. [35]
      Resolution of Hodgkin's induced ivory vertebrae. — Mandell GA Pediatric radiology (1978)
    36. [36]
      Ichthyosiform scaling in association with lymphoma. — Frost P, Shalhub S Southern medical journal (1976)
    37. [37]
      Immunohistochemical demonstration of IgG in Reed-Sternberg and other cells in Hodgkin's disease. — Garvin AJ, Spicer SS, Parmley RT, Munster AM The Journal of experimental medicine (1974)
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