Lymphoma (Hodgkin and Non-Hodgkin) - Broad Health Network

Lymphoma Treatment Guide: Understanding Hodgkin and Non-Hodgkin Lymphoma Therapies

Lymphoma is a cancer of the lymphatic system, and it primarily falls into two categories: Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL). While both originate in the lymphocytes (a type of white blood cell), they differ significantly in behavior, prognosis, and treatment strategies. In this in-depth guide, we explore current and emerging treatments for each type of lymphoma, from standard chemotherapy to cutting-edge immunotherapies.

What Is the Difference Between Hodgkin and Non-Hodgkin Lymphoma?

Hodgkin Lymphoma (HL) is identified by the presence of abnormal cells called Reed-Sternberg cells.
Non-Hodgkin Lymphoma (NHL) includes a diverse group of blood cancers with more than 60 subtypes, including diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma.

Treatment for Hodgkin Lymphoma (HL)

Goal: High Cure Rate, Minimal Long-Term Toxicity

Hodgkin Lymphoma is highly curable—even in advanced stages—with a strategic combination of chemotherapy, radiation, and immunotherapy.

Standard Treatments:

ABVD Regimen: A frontline chemotherapy protocol that includes Adriamycin, Bleomycin, Vinblastine, and Dacarbazine.
BEACOPP Regimen: Used for high-risk or advanced HL; more intensive and associated with increased side effects.

Advanced Approaches:

PET-Adapted Therapy: Treatment intensity is adjusted based on early PET scan results—patients showing good response may avoid overtreatment.
Radiation Therapy: Involved-site radiation is used selectively, especially for bulky disease or residual lymph nodes post-chemotherapy.

Targeted and Immunotherapy:

Brentuximab Vedotin: An antibody-drug conjugate targeting CD30, used in refractory HL or combined with AVD in frontline treatment.
Checkpoint Inhibitors: Drugs like nivolumab and pembrolizumab (PD-1 inhibitors) have shown excellent results in relapsed or refractory HL.

Stem Cell Transplant:

Autologous Stem Cell Transplant (ASCT) is a standard option for relapsed HL after initial chemotherapy failure.

Unique Insight:

Survivorship care is critical. Long-term survivors are monitored for cardiopulmonary toxicity, fertility issues, and secondary cancers—complications from prior chemotherapy/radiation.

Treatment for Non-Hodgkin Lymphoma (NHL)

Goal: Disease Control and Personalized Therapy

Non-Hodgkin Lymphoma is highly variable—from aggressive types requiring immediate treatment to indolent (slow-growing) forms that may not need therapy right away.

Treatment Based on Subtype:

1. Aggressive NHL (e.g., Diffuse Large B-Cell Lymphoma – DLBCL)

R-CHOP Regimen: The standard of care, combining Rituximab with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone.
CNS Prophylaxis: Given in high-risk cases to prevent spread to the brain or spinal cord.
CAR-T Cell Therapy: Offered to relapsed or refractory patients not responding to chemotherapy.

2. Indolent NHL (e.g., Follicular Lymphoma, Marginal Zone Lymphoma)

Watchful Waiting: No treatment needed unless symptoms arise.
Immunotherapy: Monoclonal antibodies like Rituximab or Obinutuzumab are used alone or with chemotherapy.
Radioimmunotherapy: Targeted radiation attached to antibodies, delivering radiation directly to lymphoma cells.

New & Emerging Lymphoma Treatments in 2025

CAR-T Cell Therapy for Lymphoma

In 2025, CAR-T cell therapy continues to expand beyond aggressive B-cell lymphomas into mantle cell lymphoma and some T-cell lymphomas.
Clinical trials are exploring dual CAR-T constructs and off-the-shelf allogeneic CAR-T products for broader availability.

Targeted Therapy for NHL

Personalized genomic testing enables selection of agents targeting mutations like EZH2, MYD88, and BCL2.
Combinations of targeted therapy with immunotherapy show promising synergy in relapsed disease.

Stem Cell Transplant in Lymphoma

Remains a curative option for chemosensitive, relapsed lymphoma.
Ongoing research focuses on conditioning regimens that reduce toxicity and improve immune reconstitution

3. Mantle Cell Lymphoma (MCL)

Treated with intensive chemo-immunotherapy, often followed by stem cell transplant in younger patients.
Newer agents include ibrutinib (BTK inhibitor) and venetoclax (BCL-2 inhibitor).

Emerging Therapies & Clinical Trends in Lymphoma

1. Personalized Medicine

Genomic profiling of lymphoma cells helps identify actionable mutations and optimize therapy.
Liquid biopsy techniques are emerging to track lymphoma in real-time without invasive procedures.

2. Bispecific Antibodies

These new drugs bind to both cancer cells and immune cells, bringing them together for a more targeted immune attack (e.g., glofitamab, epcoritamab).

3. Microbiome Modulation

Research shows that gut microbiota can affect the immune response to lymphoma therapies—paving the way for diet- or probiotic-enhanced treatment outcomes.

Lymphoma Survivorship and Long-Term Care

Regular follow-up includes imaging, blood tests, and late effects monitoring (e.g., heart function, secondary malignancy risk).
Psychosocial support and nutritional counseling are becoming essential elements of survivorship plans.

Neuromodulation

Orthopaedics

Neurosurgery

Spine Care

Neurology

Transplants

Let Us Help You