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

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Lymphomas are cancers that develop within the lymphatic system. The lymphatic system is a network of vessels, nodes, and ducts throughout the body. It is a crucial element of the immune system.

HL and NHL are the two main forms of lymphoma, which both begin in white blood cells.

HL

According to a 2022 article, HL has two subtypes — nodular lymphocyte-predominant HL and classical HL. Around 95% of HLs are classical.

Scientists further divide classical HL into the following categories:

• nodular sclerosis
• lymphocyte-rich
• mixed cellularity
• lymphocyte-depleted

NHL

According to another 2022 article, scientists classify NHL according to the affected cell. NHL affects T cells or B cells, which are different kinds of white blood cells.

There are several forms of NHL. Some common T cell NHLs include:

• enteropathy-associated T cell lymphoma
• anaplastic large cell lymphoma
• adult T cell lymphoma

Some common B cell NHLs include:

• diffuse large B cell lymphoma
• follicular lymphoma
• Burkitt lymphoma

Experts state that people with HL have higher amounts of Reed-Sternberg cells. These are abnormal white blood cells that contain more than one nucleus. These cells are largely absent from people with NHL.

Alongside this disparity in levels of Reed-Sternberg cells, there are other important differences between HL and NHL.

The following table outlines some differences between HL and NHL:

A relative survival rate helps to give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.

For example, if the 5-year relative survival rate is 70%, a person with the condition is 70% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition is going to affect them.

This section discusses other important facts about lymphoma prevalence.

HL

According to the American Cancer Society (ACS), there were 8,540 new cases of HL in the United States in 2022.

These cancers are most common in younger adults, especially in people who are in their 20s. The prevalence typically lowers after a person’s 20s before rising again after the age of 55.

The Surveillance, Epidemiology, and End Results (SEER) Program states there are 2.6 cases of HL per 100,000 people per year.

NHL

According to the ACS, there were 80,470 new cases of NHL in the U.S. in 2022.

It can affect people of any age. However, over half of people with NHL develop this condition after the age of 64.

SEER states there are 19 new cases of NHL per 100,000 people per year.

HL and NHL have several symptoms in common. However, there are some important differences in symptoms.

HL

As the ACS explains, enlarged lymph nodes are the most common symptom of HL. These will often present as bumps or lumps under the skin. This could be around the neck, groin, or underarm area.

Other symptoms of HL include:

• appetite loss
• itching
• fatigue

People with HL can also develop “B symptoms.” These include:

• significant sweating at night
• an infection-free fever, which may keep returning
• losing at least 10% of body weight within 6 months

These B symptoms are less common than swollen lymph nodes.

NHL

People with NHL also develop swollen lymph nodes. However, the ACS lists other common symptoms of NHL, which include:

• appetite loss
• itching
• fatigue
• abdominal swelling
• quickly feeling full
• chest pain or pressure
• coughing
• shortness of breath
• bleeding or bruising easily

People with NHL may also develop the B symptoms, as listed above.

HL and NHL have important differences in outlook.

HL

SEER states the following 5-year relative survival rates based on each stage of HL:

NHL

SEER states the following 5-year relative survival rates based on each stage of NHL:

The following outlines some causes and risk factors for HL and NHL.

HL

HL develops when white blood cells start to grow unusually.

Experts are not sure why this process occurs. However, the ACS does list some factors that increase the risk of HL.

These include:

• having had an Epstein-Barr virus infection
• being between 20–30 years of age or being older than 55
• having a weakened immune system
• being male

An individual is also at greater risk of HL if a relative has the disease.

NHL

Scientists do not know what causes NHL. However, they have identified a wide range of risk factors for this condition.

The ACS lists them as follows:

• being older
• being white
• having a family history of NHL
• having experienced radiation exposure
• having a weakened immune system
• having an autoimmune disease

Some infections are also risk factors for NHL. These include:

• Epstein-Barr virus
• human T cell lymphotropic virus infection
• human herpes virus 8 infection

The main treatment options for HL and NHL partially overlap. Specific treatment details will vary from case to case.

HL

As the National Cancer Institute (NCI) explains, doctors have several ways to treat HL. Treatment methods include:

• chemotherapy, with or without stem cell transplants
• radiation therapy
• immunotherapy
• targeted therapy

Some forms of treatment may be unsuitable for pregnant individuals. For instance, many chemotherapies can be harmful to the fetus.

NHL

The NCI lists the main forms of treatment for NHL:

• chemotherapy, with or without stem cell transplants
• radiation therapy
• immunotherapy
• targeted therapy
• surgery
• antibiotic therapy
• plasmapheresis

Doctors might also recommend watchful waiting, which involves pausing treatment to monitor how the condition progresses.

HL and NHL are the two main types of cancers of the lymphatic system. Although both begin in the white blood cells, they develop in different areas of the body and have different symptoms and outlooks.

If people notice any symptoms of either type of lymphoma, they should contact a doctor.