ONCOLOGY

CLASSICAL HODGKIN’S LYMPHOMA (cHL)

 

Lymphoma is a cancer of the blood that develops when lymphocytes, a type of white blood cell which normally helps your body fight infections, develop abnormally.¹

 

Classical Hodgkin lymphoma contains cancer cells called Reed-Sternberg cells which are an abnormal type of lymphocyte.^1,2

SUBTYPES OF cHL

There are four subtypes of classical Hodgkin lymphoma. They are named after the appearance of the lymphoma cells and the cells surrounding them:^1,2

SIGNS AND SYMPTOMS ^1,5

The symptoms that may be experienced are:

Appearance of a lump

Usually in the groin, in the neck or under the arm

Fever without an infection

This can be intermittent over several weeks

Drenching night sweats

Without another cause, such as the flu or an infection

Unexplained weight loss

Occurring without intention or any effort

Itching skin

Which could be worse at night or in hot weather

Fatigue (feeling tired)

A feeling of being washed-out or exhausted after doing very little

Loss of appetite

Loss of interest in food is a possible symptom

RISK FACTORS ⁶

The risk factors include: SEE MORE SEE LESS

Epstein-Barr virus infection ⁶

People who have previously been infected with Epstein-Barr virus have an increased risk

---

Age

cHL is most common in people in their 20s and those above the age of 55

---

Gender

cHL is slightly more common in men

---

A weak immune system

Caused by infection with HIV or medications

---

Family history

The risk is higher if a sibling, especially a twin has HL

---

WAYS TO LOWER THE RISK

STOP SMOKING

Poisons in cigarette smoke can weaken the body’s immune system, making it harder to kill cancer cells.⁷
Giving up smoking is an important step in preventing cancers, including Hodgkin lymphoma.^7-9

 

Your doctor can assist you to stop smoking.

AVOID EXPOSURE TO CHEMICALS

especially formaldehyde and pesticides ^10-12

Formaldehyde is used in a variety of household products, such as paint and other do-it-yourself (DIY) products.¹³

Always adhere to safety instructions stipulated on DIY and pest control products, e.g. wearing protective clothing such as masks and gloves.

LOCAL TREATMENT OPTIONS FOR cHL

CHEMOTHERAPY

Chemotherapy involves using medicines to destroy cancerous cells by preventing them from growing, dividing and creating more cells. Chemotherapy consists of a particular number of cyclical treatments given over a prescribed set of weeks or months.¹⁴

RADIATION THERAPY

Radiation therapy involves the destruction of cancer cells using high energy x-rays or protons. The type of radiation used for Hodgkin Lymphoma is known as external-beam radiation. It is administered through a machine located outside of the body. The treatment involves a series of therapy sessions given over a specific number of days or weeks.¹⁴

STEM CELL OR BONE MARROW TRANSPLANTATION

Stem cell transplantation is a treatment involving haematopoietic stem cells (specialised cells) which are collected from peripheral blood (blood circulating through the body). These cells are blood-forming cells and are found in both bone marrow and the bloodstream. The cells can also be collected directly from the bone marrow, in this case the procedure is
called a bone marrow transplant.¹⁴

IMMUNOTHERAPY

Immunotherapy uses a person’s natural defences to fight cancer. It makes use of materials made in a laboratory or those that are made by the body itself.
The aim of the therapy is to improve the immune system’s ability to attack cancer cells.^14,15

REFERENCES:

1. Lymphoma Action. Hodgkin Lymphoma, 8th edition. Updated November 2022. Available at: https://lymphoma-action.org.uk/sites/default/files/media/documents/2023-01/LA_Hodgkin%20Lymphoma%20DIGITAL.pdf. Accessed: February 2023.
2. American Cancer Society. What Is Hodgkin Lymphoma? Updated May 2018. Available at: https://www.cancer.org/cancer/hodgkin-lymphoma/about/what-is-hodgkin-disease.html. Accessed: February 2023.
3. Verburgh E and Antel K. Approach to lymphoma diagnosis and management in South Africa. SAMJ. 2019;109(10):715-718.
4. Naidoo N, Abayomi A, Locketz C, et al. Incidence of Hodgkin lymphoma in HIV-positive and HIV-negative patients at a tertiary hospital in South Africa (2005 – 2016) and comparison with other African countries. SAMJ. 2018;108(7):563-567.
5. American Cancer Society. Signs and Symptoms of Hodgkin Lymphoma. Updated May 2018. Available at: https://www.cancer.org/cancer/hodgkin-lymphoma/detection-diagnosis-staging/signs-and-symptoms.html. Accessed: February 2023.
6. American Cancer Society. Hodgkin Lymphoma Risk Factors. Updated May 2018. Available at: https://www.cancer.org/cancer/hodgkin-lymphoma/causes-risks-prevention/risk-factors.html. Accessed: February 2023.
7. Centers for Disease Control (CDC). Smoking and Cancer. Available at: https://www.cdc.gov/tobacco/campaign/tips/diseases/cancer.html. Accessed: February 2023.
8. Taborelli M, Montella M, Libra M, et al. The dose-response relationship between tobacco smoking and the risk of lymphomas: a case-control study. BMC Cancer. 2017;17(1):421.
9. Willett EV, Connor S, Smith AG, et al. Does Smoking or Alcohol Modify the Risk of Epstein-Barr Virus-Positive or -Negative Hodgkin Lymphoma? Epidemiology. 2007;18(1):130-136.
10. Freeman LEB, Blair A, Lubin JH, et al. Mortality From Lymphohematopoietic Malignancies Among Workers in Formaldehyde Industries: The National Cancer Institute Cohort. J Natl Cancer Inst. 2009;101(10):751-761.
11. Kwon S-C, Kim I, Song J, et al. Does formaldehyde have a causal association with nasopharyngeal cancer and leukaemia? Annals of Occupational and Environmental Medicine. 2018;30:5. 
12. Navaranjan G, Hohenadel K, Blair A, et al. Exposures to multiple pesticides and the risk of Hodgkin lymphoma in Canadian men. Cancer Causes Control. 2013;24:1661-1673.
13. United States Environmental Protection Agency (US EPA). Facts About Formaldehyde. Available at: https://www.epa.gov/formaldehyde/facts-about-formaldehyde#research. Accessed: February 2023.
14. Cancer.net. American Society of Clinical Oncology (ASCO). Lymphoma – Hodgkin: Types of Treatment. Updated March 2022. Available at: https://www.cancer.net/cancer-types/lymphoma-hodgkin/types-treatment. Accessed: February 2023.
15. Cancer.net. American Society of Clinical Oncology (ASCO). ASCO answers. Understanding Immunotherapy. Available at: https://www.cancer.net/sites/cancer.net/files/asco_answers_immunotherapy.pdf. Accessed: February 2023.

ZA-NON-00703 03/25