How Is Hodgkin Lymphoma Different from Non-Hodgkin Lymphoma?

Key Takeaways

• Hodgkin and non-Hodgkin lymphoma are both types of blood cancer, but they have significant differences in treatments, prognosis, and makeup.
• Hodgkin lymphoma is marked by the presence of Reed-Sternberg cells, which are large, abnormal, mutated B-cells.
• Non-Hodgkin lymphoma does not have Reed-Sternberg cells, and it originates from B-cells, T-cells, or natural killer cells.
• Symptoms of lymphoma include painless swollen lymph nodes, extreme fatigue, chest discomfort, and B symptoms, which include high fevers, drenching night sweats, and unexplained weight loss.
• Regional Cancer Care Associates provides comprehensive treatment for patients with Hodgkin lymphoma and non-Hodgkin lymphoma in New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area.

What Is Lymphoma?

Lymphoma is a group of blood cancers that form in the white blood cells (lymphocytes called B-cells or T-cells) of the lymphatic system. It begins with an abnormal change in a single white blood cell, which then causes the cancerous white blood cells to multiply.

Lymphoma differs from other blood cancers, such as leukemia and multiple myeloma. Lymphoma affects lymphocytes in the lymphatic system, while leukemia mainly impacts white blood cells in the bone marrow and blood, and multiple myeloma affects plasma cells in the bone marrow.

There are two main types of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Hodgkin lymphoma is rare, with around 8,920 new cases estimated in 2026, according to the American Cancer Society (ACS). On the other hand, non-Hodgkin lymphoma is one of the most common cancers in the United States. ACS estimates that about 79,320 people will be diagnosed with NHL in 2026.

Hodgkin Lymphoma (HL): What You Need to Know

Hodgkin lymphoma is a unique type of lymphoma that is defined by the presence of Hodgkin cells and Reed-Sternberg (RS) cells. RS cells form from mutated B cells, and they have a large, abnormal appearance that often resembles “owl eyes.” There are two main types of Hodgkin lymphoma:

• Classical Hodgkin lymphoma (cHL): This is the most common type. It can be further categorized into subtypes: nodular sclerosis (NSCHL), mixed cellularity (MCCHL), lymphocyte-depleted, and lymphocyte-rich.
• Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL): This is the rarest form of Hodgkin lymphoma, which is characterized by “popcorn cells,” which are variants of Reed-Sternberg cells.

Hodgkin lymphoma most commonly begins in the lymph nodes located in the upper body, such as in the neck, chest, or underarms, although it can also start in other lymph nodes.

What Are Hodgkin Lymphoma Symptoms?

Hodgkin lymphoma often causes recognizable symptoms, such as:

• Painless swollen lymph nodes, typically in the neck, armpit, or groin (most common first sign)
• Itching (pruritus)
• Fatigue
• Chest discomfort
• Pain in the swollen lymph nodes immediately after drinking alcohol

Hodgkin lymphoma can also cause what are known as B symptoms. These include unexplained fevers, drenching night sweats, and unintentional weight loss.

It is important to note that the great majority of individuals who experience one or more of the symptoms listed above will not have Hodgkin lymphoma. Nonetheless, it is important to consult a physician about these symptoms, particularly if they are pronounced, arose suddenly, or have persisted for an extended period. Prompt evaluation will enable a doctor to address your concerns and to provide a treatment plan for whatever condition may be responsible for the symptoms.

Who Gets Hodgkin Lymphoma?

Hodgkin lymphoma primarily affects people of certain ages. It is most likely to develop in adolescents and young adults in their teens and 20s, and older adults aged 55 and older. It is slightly more common in males. Known risk factors include:

• Having a history of Epstein-Barr virus (EBV)
• Having a history of human immunodeficiency virus (HIV) infection
• Having another type of immunosuppression
• Having a close family member who has had the disease

What Are the Stages of Hodgkin Lymphoma?

When a person is diagnosed with Hodgkin lymphoma, they will be given a stage, which indicates how far the cancer has spread from the originating lymph tissue. These stages are based on the Lugano classification system, which includes:

• Stage I: This is when the cancer is confined to a single lymph node region or lymphoid organ, or when it’s in one localized area of a single organ outside the lymph system.
• Stage II: This is when the cancer affects two or more lymph node regions, but they are on the same side of the diaphragm. It can also mean the disease has spread locally from one lymph node group into a nearby organ.
• Stage III: This is when the cancer is found in lymph node regions on both sides of the diaphragm. It may also involve the spleen or a localized area of an organ outside the lymph system.
• Stage IV: This is when the cancer has spread diffusely to one or more organs outside of the lymph system, such as the lungs, liver, or bone marrow.

The stage of the cancer will help determine the treatment plan and prognosis.

What Are the Treatment Options for Hodgkin Lymphoma?

The treatment plan for Hodgkin lymphoma will depend on several factors, including the patient’s overall health, the stage of their cancer, and more. Options include:

• Combination chemotherapy: This is the standard first-line regimen, which typically includes adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD).
• Targeted therapy: For patients with relapsed or refractory HL, drugs such as brentuximab vedotin may be used to attack specific proteins found on the cancer cells.
• Radiation therapy: Radiation therapy, which uses high-energy rays directed at localized areas, may be used after chemo to target affected lymph nodes.
• Immunotherapy: A type of immunotherapy called checkpoint inhibitors can help the patient’s immune system recognize and attack cancer cells.

What Is the Prognosis for Hodgkin Lymphoma?

Hodgkin lymphoma is a highly curable cancer, due in part to the fact that Reed-Sternberg cells are highly sensitive to treatment. According to ACS, the five-year survival rate for localized HL is 93%, regional HL is 95%, and distant HL is 84%.

Non-Hodgkin Lymphoma (NHL): What You Need to Know

Non-Hodgkin lymphoma is a term used to describe several types of lymphoma. These cancers do not have Reed-Sternberg cells, distinguishing them from Hodgkin lymphoma. Instead, non-Hodgkin lymphoma originates from B-cells, T-cells, or natural killer (NK) cells. It typically starts in the lymph nodes or lymph tissue, but it can also affect the skin.

There are more than 60 subtypes of non-Hodgkin lymphoma, which are classified by the characteristics of the lymphoma cells. These subtypes generally fall within two groups:

• Low-grade: Low-grade NHL, also called indolent lymphoma, spreads slowly, which means that it can sometimes be monitored and does not need immediate treatment.
• High-grade: This type is also called aggressive lymphoma. It spreads quickly and generally requires immediate treatment.

The subtype that a patient has will determine which treatment methods are used.

What Are Non-Hodgkin Lymphoma Symptoms?

People with non-Hodgkin lymphoma can experience various symptoms, including:

• Swollen lymph nodes, which are often painless
• Abdominal pain or fullness due to an enlarged spleen/liver
• Chest pain
• Coughing
• Shortness of breath

B symptoms that can appear in aggressive NHL include skin rashes or lumps, along with unexplained fevers, weight loss, and night sweats.

As above, many individuals experiencing one or more of these symptoms will not have the disease. However, it is important to report these symptoms to a physician.

Who Gets Non-Hodgkin Lymphoma?

Non-Hodgkin lymphoma is most common in adults aged 60 and older, especially white males. The exact cause is unknown, but some factors that can increase a person’s risk include:

• Weakened immune system: People with weak immune systems, whether from organ transplant medications, HIV, or inherited immune conditions, can have a heightened risk.
• Autoimmune diseases: People with conditions such as rheumatoid arthritis, lupus, Sjögren disease, or celiac disease may have an increased risk.
• Specific viral or bacterial infections: People who have certain infections, including Epstein-Barr virus (mononucleosis), hepatitis C, or Helicobacter pylori (H. pylori), have an increased vulnerability.

Individuals with long-term exposure to certain pesticides or herbicides may also be more likely to develop NHL.

What NHL Subtypes Does RCCA Treat?

Physicians at Regional Cancer Care Associates have vast experience in treating blood cancers, including various NHL subtypes. These include:

• Diffuse large B-cell lymphoma (DLBCL): This is the most common aggressive NHL. It affects B-lymphocytes (white blood cells), resulting in fast-growing tumors that form in the lymph nodes or extranodal sites.
• Follicular lymphoma: This is the most common indolent NHL, which forms in B-cells and is generally considered incurable. However, its slow-growing nature and effective modern treatments mean most patients can live for decades.
• Mantle cell lymphoma: This is a rare and aggressive form of NHL that begins in the mantle zone of the lymph nodes. It impacts B-cell lymphocytes and is marked by a specific genetic mutation that overproduces a protein called cyclin D1, causing uncontrolled cancer cell growth.

Using the subtype and stage of the cancer, RCCA’s oncology team can develop a comprehensive treatment plan.

What Are the Treatments for Non-Hodgkin Lymphoma?

The best treatment option for non-Hodgkin lymphoma will depend on the subtype, stage, and the patient’s health. However, the treatment options typically include:

• R-CHOP chemoimmunotherapy: A combination chemoimmunotherapy regimen, known as R-CHOP, is the standard for DLBCL. It effectively treats around 60% to 70% of patients.
• Targeted therapies: For aggressive subtypes, such as mantle cell lymphoma, or patients with relapsed or refractory DLBCL, targeted therapies like monoclonal antibodies and CAR-T cell therapy may be used.
• Radiation therapy: For localized NHL, external beam radiation therapy may be used to control the tumor.

For indolent (slow-growing) NHL, doctors may recommend a watch-and-wait approach. This involves regularly monitoring the cancer to ensure it isn’t spreading or growing. If it is, other treatments will begin.

Hodgkin vs. Non-Hodgkin Lymphoma: Side-by-Side Comparison

 

Feature	Hodgkin Lymphoma	Non-Hodgkin Lymphoma
Reed-Sternberg Cells	Yes	No
Age at Diagnosis	Young adulthood (ages 15–24) or late adulthood ( 60 and older)	Late adulthood (60 and older)
Number of Subtypes	Two: classic Hodgkin lymphoma (cHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL)	60-plus subtypes
Typical Spread Pattern	Orderly, contiguous manner through local lymphatic pathways	Unpredictable, non-contiguous pattern
B Symptoms Frequency	25% to 30%	25% to 33%
Curability	Highly treatable	Depends on the subtype
Most Common First-Line Treatment	Combination chemotherapy	Immunochemotherapy regimen (R-CHOP)

 

Find State-of-the-Art Lymphoma Care Near You in NJ, CT, MA, and the Washington, D.C., Area

Whether you have Hodgkin lymphoma or non-Hodgkin lymphoma, high-quality care from an expert hematology-oncology team is required to give you the best possible outcome. Many individuals diagnosed with either type of cancer turn to Regional Cancer Care Associates (RCCA) for treatment. At RCCA, hematologist-oncologists are highly experienced in treating various blood cancers, including both Hodgkin and non-Hodgkin lymphoma. RCCA also offers CAR-T cell therapy and clinical trials, helping patients access innovative treatment options.

RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.

To learn more about RCCA, call 844-346-7222 or contact RCCA online.

Frequently Asked Questions About Lymphoma

What is the difference between Hodgkin and non-Hodgkin lymphoma?

The main difference between Hodgkin and non-Hodgkin lymphoma is the specific lymphocyte (white blood cell) involved. Hodgkin lymphoma is marked by the presence of Reed-Sternberg cells, while non-Hodgkin lymphoma does not have these cells. It is characterized by cancers originating from B-cells, T-cells, or natural killer cells.

Which type of lymphoma is more common?

Non-Hodgkin lymphoma is much more common than Hodgkin lymphoma, and it is one of the most common cancers in the U.S.

Which type of lymphoma is more curable?

Hodgkin lymphoma has a higher curability than non-Hodgkin lymphoma, which will vary based on the subtype.

What are the symptoms of lymphoma?

The symptoms of lymphoma include:

• Painless swollen lymph nodes
• Fatigue
• Chest discomfort
• B symptoms, which include unexplained fevers, drenching night sweats, and unexplained weight loss

How is lymphoma diagnosed?

To diagnose lymphoma, doctors use a comprehensive clinical assessment, which includes a physical exam, blood work, imaging scans, and a tissue biopsy. The tissue biopsy is required to conclusively diagnose lymphoma.

What is the treatment for non-Hodgkin lymphoma?

The first-line treatment for non-Hodgkin lymphoma is an immunochemotherapy regimen known as R-CHOP. It stands for a combination of five drugs: Rituximab, Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), and Prednisone.

Can lymphoma come back after treatment?

Yes, it’s possible for lymphoma to come back after treatment. The risk of recurrence will depend on several factors, including the type and subtype of the cancer, the stage, and what treatments were used.

What is the survival rate for non-Hodgkin lymphoma?

The survival rate for non-Hodgkin lymphoma varies heavily based on the subtype and stage of the cancer. For diffuse large B-cell lymphoma, the five-year survival rate for localized cancer is 74%, and it is 58% for distant cancer. For follicular lymphoma, the five-year survival rate for localized cancer is 97%, and the rate for distant cancer is 86%.