Hodgkin’s Lymphoma: An Environmental Scan
Table of Contents
3.3 Differences Between Hodgkin’s and Non-Hodgkin’s Lymphomas
There are a few distinct differences between HL and NHL including how the disease spreads, where tumors are most commonly found in the body and variances in symptomology experienced by individuals. Additionally, treatment protocols are very different. HL is not as common as NHL and the age of onset for HL occurs in a bimodal (2 age time points) distribution with the average age of onset at 28 years and a less substantive peak after age 55, whereas it is less common to see cases of NHL in people under age 50 (National Cancer Institute 2007a). For both HL and NHL the most common location of the tumors is in the lymph nodes and occurs above the collarbone (National Cancer Institute 2010).
Specific to HL, malignancies are also found in the chest area, whereas in NHL tumors in the abdomen are more common. Similarly, in HL as few as 4% of cases demonstrate cancer outside the lymph nodes, which differs significantly in NHL where nearly one quarter of all patients have confirmed lymphoma outside the lymph nodes. In terms of the symptoms of both HL and NHL, they are quite similar; however, approximately 40% of individuals with HL will show symptoms that apply to the whole body or systemic symptoms such as weight loss, night sweats and/or fevers. In NHL systemic symptoms are not as common.
An important difference between both lymphomas surrounds the progression of disease. In HL, the progression is often quite orderly spreading in a downward pattern from the initial site to each lymph node and rarely diagnosed in stage IV. Additionally, when HL first presents below the diaphragm it most frequently progresses to the spleen. Conversely, in NHL nearly 40% of diagnosed cases are at stage IV, which are more likely to spread and not as predictable in terms of their progression.