Hodgkin Lymphoma Treatment in Delhi – NCR

A diagnosis of Hodgkin lymphoma can feel overwhelming, but it is helpful to know that it is among the more treatable blood cancers, especially when it is identified and managed with a well-planned approach. This page explains the condition in simple language: how it shows up, how it is diagnosed, what treatment involves, and what to expect along the way.

What Is Hodgkin Lymphoma?

Hodgkin lymphoma is a cancer of the lymphatic system, the body’s infection-fighting network of lymph nodes, spleen and related tissues. It starts in white blood cells called lymphocytes and is identified by large abnormal cells known as Reed-Sternberg cells.

There are two main types:

• Classic Hodgkin lymphoma: the most common type, making up about 95% of cases.
• Nodular lymphocyte-predominant Hodgkin lymphoma: a rarer, usually slower-growing type that is treated differently.

It can occur at any age, but is most often seen in young adults and again in older adults. It differs from non-Hodgkin lymphoma, which does not have Reed-Sternberg cells and is treated differently.

Knowing the exact type is the first step towards choosing the right treatment.

What Are the Symptoms of Hodgkin Lymphoma?

The most common first sign is a painless swelling of lymph nodes in the neck, armpit or groin. Some people also have fever, drenching night sweats, unexplained weight loss, persistent itching or tiredness.

Other symptoms depend on where the lymph nodes are enlarged. Swollen nodes in the chest may cause a persistent cough or breathlessness. Fever, night sweats and weight loss together are called “B symptoms” and help doctors understand the extent of the disease.

Many causes of swollen glands, such as infections, are harmless. Swelling that lasts more than two to three weeks, keeps growing, or comes with the symptoms above should be examined by a doctor.

What Causes Hodgkin Lymphoma and Who Is at Risk?

The exact cause of Hodgkin lymphoma is not known. It develops when a lymphocyte changes and begins to multiply uncontrollably. Certain factors are linked to a higher risk, although most people with these factors never develop the disease.

Known risk factors include:

• Past infection with the Epstein-Barr virus (the virus that causes glandular fever), which is found in the cancer cells in a proportion of cases
• A weakened immune system, including HIV infection or immunosuppressant medicines
• A family history of Hodgkin lymphoma
• Age, with two peaks: young adulthood and later life

Hodgkin lymphoma is not caused by anything you did or did not do, and there is no proven way to prevent it.

How Is Hodgkin Lymphoma Diagnosed and Staged?

Hodgkin lymphoma is confirmed by a lymph node biopsy, where an affected node is removed and examined under the microscope. Imaging and blood tests then show how far the disease has spread, which is called staging.

The usual evaluation includes:

• Lymph node biopsy with special stains (such as CD30 and CD15) to confirm the type
• PET-CT scan to see the extent of disease and to serve as a baseline for judging response
• Blood tests including blood counts, kidney and liver function, LDH and ESR, and screening for HIV and hepatitis B and C
• Heart and lung tests (echocardiogram, lung function) before treatment, as some medicines can affect these organs
• Bone marrow examination only in selected cases

Staging runs from Stage I to Stage IV:

• Stage I: one lymph node area
• Stage II: two or more areas on the same side of the diaphragm
• Stage III: lymph nodes on both sides of the diaphragm, or spleen involvement
• Stage IV: spread to organs such as the liver, lungs or bone marrow

The letter “A” means no B symptoms, and “B” means they are present. Stages I and II are considered early stage, and III and IV advanced stage.

An accurate stage guides the type and length of treatment you will need.

What Are the Treatment Options for Hodgkin Lymphoma?

Hodgkin lymphoma is mainly treated with combination chemotherapy, sometimes with radiotherapy, and increasingly with targeted therapy or immunotherapy. The choice depends on the type, stage, age, general health and response to treatment.

The main options are:

• Chemotherapy: Combination regimens such as ABVD or AVD are widely used. A more intensive regimen (escalated BEACOPP) may be considered for selected higher-risk disease.
• Targeted therapy: Brentuximab vedotin targets the CD30 protein on Hodgkin cells and is used with chemotherapy in selected patients or in relapse.
• Immunotherapy: Checkpoint inhibitors such as nivolumab or pembrolizumab help the immune system recognise and attack lymphoma cells. Nivolumab combined with AVD has been studied as first-line treatment in advanced-stage disease, and these medicines are also used for relapsed disease.
• Radiotherapy: Low-dose radiation to the affected area, mostly in early-stage disease or for bulky disease.
• Stem cell transplant: Used when the disease returns or does not respond to initial treatment.

Treatment is often guided by a mid-treatment PET-CT scan, which shows how well the lymphoma is responding. This allows the plan to be adjusted: stepping up therapy when needed, and avoiding unnecessary treatment when the response is good.

Your hematologist will explain which approach suits your situation, along with its benefits and risks.

How Does Treatment Differ for Early-Stage and Advanced-Stage Hodgkin Lymphoma?

Early-stage disease is usually treated with a short course of chemotherapy, with or without radiotherapy. Advanced-stage disease is treated with a longer course of combination chemotherapy, sometimes with targeted therapy or immunotherapy.

• Early stage (I–II): A few cycles of chemotherapy, followed by radiotherapy in some patients, depending on risk features and PET-CT response.
• Advanced stage (III–IV): Usually about six cycles of combination treatment, with the regimen selected based on age, fitness, disease features and response on PET-CT.

Each cycle is generally given every two to three weeks, usually as a day-care or short-stay procedure, so most people do not need to stay in hospital throughout.

Matching the intensity of treatment to the stage helps control the disease while limiting side effects.

What Happens If Hodgkin Lymphoma Returns or Does Not Respond to Treatment?

Even if Hodgkin lymphoma returns after treatment, or does not fully respond, it can often still be treated. Options are chosen based on how long the remission lasted and the person’s overall health.

Treatment may include:

• Second-line (salvage) chemotherapy to bring the disease under control
• Autologous stem cell transplant, where your own stem cells are collected, stored, and returned after high-dose chemotherapy
• Brentuximab vedotin or immunotherapy with checkpoint inhibitors, used before or after transplant in suitable patients

Relapse needs a fresh, careful evaluation, and a repeat biopsy and PET-CT scan are usually done to confirm it.

What Are the Side Effects of Hodgkin Lymphoma Treatment and How Are They Managed?

Treatment can cause side effects, but most can be prevented or managed with supportive care. Not everyone experiences all of them, and they vary with the medicines used.

Common effects include:

• Low blood counts, leading to tiredness, infections or easy bruising
• Nausea and vomiting, usually controlled well with anti-sickness medicines
• Hair thinning or hair loss, tingling in the hands and feet, and mouth sores
• Rarely, effects on the lung or heart, which is why tests are done before treatment
• With immunotherapy, immune-related effects on the thyroid, skin, bowel or lungs, which are monitored with regular blood tests

Your care team will check blood counts regularly and may give growth-factor injections and anti-infection medicines when needed. Please contact your doctor promptly for fever, breathlessness, severe vomiting or any new symptom.

Open communication with your care team helps side effects get picked up and treated early.

What Is the Outlook for Hodgkin Lymphoma?

The outlook for Hodgkin lymphoma is generally encouraging, and many people achieve long-term remission. Published data from large studies report five-year survival of around nine in ten people overall, and higher in early-stage disease.

These figures are population averages and cannot predict what will happen for any one person. Outcomes depend on the stage, the type, age, general health and how the lymphoma responds to treatment. Some people also experience late effects of treatment years later, so long-term monitoring matters.

Regular follow-up visits, with examination and scans when needed, help ensure that any change is noticed early.

Where Can You Get Hodgkin Lymphoma Treatment in Delhi-NCR?

Hodgkin lymphoma treatment in Delhi-NCR is available at hospitals with hematology and medical oncology departments, along with PET-CT imaging, pathology, radiotherapy and stem cell transplant facilities. You are free to choose any specialist and hospital you are comfortable with.

Dr. Sanjeev Kumar Sharma is Principal Director of Hemato-Oncology & BMT at Paras Health, Gurugram, with over 20 years of clinical experience in hematology and blood cancer care. For guidance, you may consult Dr. Sanjeev or any hematologist of your choice.

Bring your previous reports, biopsy slides or blocks, and scans to your first visit, as these help the doctor plan your care. A second opinion is also a reasonable step at any point.

Medical Disclaimer: The information on this page is provided for educational purposes only and should not be used as a substitute for medical advice. Treatment recommendations vary from person to person and should always be based on an individual consultation and clinical evaluation by a qualified healthcare professional.