Hodgkin’s vs. non-Hodgkin’s: Compare causes, symptoms, treatments, & more

Non-Hodgkin’s lymphoma is more common than Hodgkin’s lymphoma, with around 70,000 new cases each year in the United States versus 8000 for Hodkin's disease

By Gerardo Sison, Pharm.D. | Aug. 24, 2021

Hodgkin’s and non-Hodgkin’s lymphoma (NHL) are two types of lymphomas. These cancers affect the lymphocytes, which are important white blood cells of the immune system that fight off germs. Because they have similar names, Hodgkin’s and non-Hodgkin’s lymphoma can often be confused for one another.

The main difference between these lymphomas is in the type of lymphocyte they affect. Hodgkin’s lymphoma causes mutations that lead to the development of abnormal lymphocytes called Reed-Sternberg cells. These cells are large, abnormal cells that are characteristic of Hodgkin’s lymphoma. Hodgkin’s and non-Hodgkin’s lymphoma can also differ in treatment options and risk factors.

Continue reading to learn more about the differences between Hodgkin’s and non-Hodgkin’s lymphoma.

Causes

Hodgkin’s

The exact cause of Hodgkin’s lymphoma, sometimes referred to as Hodgkin’s disease, is unknown. However, DNA mutations, or changes, in B cell lymphocytes lead to the development of Reed-Sternberg cells that can grow and spread to other parts of the body. Exposure to radiation or other cancer-causing substances can also accelerate the development of cancers like Hodgkin’s lymphoma. Cancer research is still ongoing to determine the exact genetic changes and DNA mutations that cause Hodgkin’s lymphoma.

Non-Hodgkin’s

The exact cause of non-Hodgkin’s is unknown. Like other forms of blood cancers, including Hodgkin’s lymphoma, non-Hodgkin’s lymphoma is linked to DNA mutations in lymphocytes. Mutations in lymphocytes can lead to abnormal cancer cells that can spread throughout the lymphatic system to other parts of the body. Exposure to certain infections and carcinogenic substances can contribute to lymphocyte changes over time.

Hodgkin’s vs. non-Hodgkin’s causes
Hodgkin’s	Non-Hodgkin’s
Exact cause is unknown but may be attributed to DNA mutations in lymphocytes	Exact cause is unknown but may be attributed to DNA mutations in lymphocytes

Prevalence

Hodgkin’s

Hodgkin’s lymphoma is less common than non-Hodgkin’s lymphoma. Each year, Hodgkin’s lymphoma affects around 8,000 people in the United States. It is primarily diagnosed in people aged 20 to 40 years, although many people are diagnosed with Hodgkin’s at age 55 and older. The median age of diagnosis is 39. Hodgkin’s lymphoma is more common in men than in women, and, in children, 85% of cases arise in boys. Overall, Hodgkin’s lymphoma accounts for around 6% of childhood cancers diagnosed.

Non-Hodgkin’s

Non-Hodgkin’s lymphoma is more common than Hodgkin’s lymphoma, with around 70,000 new cases each year in the United States. Non-Hodgkin’s lymphoma is more common in older adults over the age of 60. The median age of diagnosis is 67. Like Hodgkin’s lymphoma, non-Hodgkin’s lymphoma is more common in men than in women. It is also common in children; non-Hodgkin’s lymphoma accounts for approximately 7% of childhood cancers diagnosed.

Hodgkin’s vs. non-Hodgkin’s prevalence
Hodgkin’s	Non-Hodgkin’s
8,000 new cases each year Median age of diagnosis is 39 More common in men than in women Accounts for 6% of childhood cancers each year	70,000 new cases each year Median age of diagnosis is 67 More common in men than in women Accounts for 7% of childhood cancers each year

Symptoms

Hodgkin’s

The most common symptoms of Hodgkin’s lymphoma include swelling of the lymph nodes that first appears in the neck, chest, or underarms. In advanced-stage disease, lymph nodes in other parts of the body can become swollen. Symptoms of Hodgkin’s lymphoma may also include what is known as the B symptoms. These symptoms consist of heavy sweating at night, high fevers, and a loss of more than 10% body weight over 6 months. Other symptoms can include lymph node pain after drinking alcohol, fatigue, chills, itchy skin, and an enlarged liver or spleen.

Non-Hodgkin’s

Swollen lymph nodes are also a common symptom in non-Hodgkin’s lymphoma. However, swelling may first appear in lymph nodes in different parts of the body, such as the groin or abdomen. Swelling can then spread to other lymph nodes as the disease progresses. B symptoms, such as night sweats, fever, and weight loss over six months, are also common with non-Hodgkin’s lymphoma depending on the severity of the cancer. Fatigue, itching, and an enlarged liver or spleen are other possible symptoms of non-Hodgkin’s lymphoma.

Hodgkin’s vs. non-Hodgkin’s symptoms
Hodgkin’s	Non-Hodgkin’s
Swollen lymph nodes Night sweats Unexplained weight loss Fever Chills Fatigue Itching Enlarged liver or spleen Increased sensitivity to alcohol	Swollen lymph nodes Night sweats Unexplained weight loss Fever Chills Fatigue Itching Enlarged liver or spleen

Diagnosis

Hodgkin’s

Hodgkin’s lymphoma is typically diagnosed by an oncologist. The doctor will first start with imaging tests, like an X-ray or MRI, and a physical exam to evaluate swelling in the lymph nodes. Lumbar punctures, blood tests, and bone marrow tests may also be performed to check for any abnormal white blood cells. To confirm a diagnosis, the doctor will have to take a biopsy sample of the swollen lymph nodes. The presence of Reed-Sternberg cells can be identified under a microscope and are unique to Hodgkin’s lymphoma.

Non-Hodgkin’s

Non-Hodgkin’s lymphoma is diagnosed in much the same way as Hodgkin’s lymphoma. An oncologist will perform a physical exam and order imaging tests to find where swollen lymph nodes are in the body. They might also order blood tests to look for any abnormalities and rule out other diseases. A bone marrow biopsy will help to confirm the presence of cancer cells. A lumbar puncture can also determine whether cancer cells have spread to the cerebrospinal fluid.

Hodgkin’s vs. non-Hodgkin’s diagnosis
Hodgkin’s	Non-Hodgkin’s
Physical exam Blood tests Imaging tests (X-ray, CT, MRI, PET scan) Bone marrow tests Lumbar puncture	Physical exam Blood tests Imaging tests (X-ray, CT, MRI, PET scan) Bone marrow tests Lumbar puncture

Treatments

Hodgkin’s

Cancer treatment typically depends on the stage of cancer, the overall health condition of the person being treated, and other factors. Hodgkin’s lymphoma is considered a fast-growing cancer, and an aggressive treatment plan is usually recommended. Treatment for Hodgkin’s lymphoma includes a combination of chemotherapy and radiation therapy. Patients that don’t respond to chemotherapy may need a stem cell transplant or treatment with a biologic agent. Immunotherapy, which is a type of treatment that uses the immune system to fight the cancer cells, may also be recommended.

Non-Hodgkin’s

Treatment for non-Hodgkin’s lymphoma depends on the type of cancer, the stage of the cancer, the overall health condition of the person being treated, and other factors. Chemotherapy alone is usually the standard treatment for non-Hodgkin’s lymphoma. Radiation therapy or stem cell transplants are other potential treatment options. Immunotherapy may also be recommended in some cases. Sometimes, early treatment may not be needed for non-Hodgkin’s, and a doctor may recommend to watch and wait for symptoms to appear before treating it.

Hodgkin’s vs. non-Hodgkin’s treatments
Hodgkin’s	Non-Hodgkin’s
Chemotherapy Radiation Stem cell transplant Immunotherapy	Chemotherapy Radiation Stem cell transplant Immunotherapy

Risk factors

Hodgkin’s

There are several risk factors that may play a role in the development of Hodgkin lymphoma. This type of lymphoma is more likely to occur in men than in women. According to the National Cancer Institute, those between the ages of 20 and 40 or over 55 years old have a higher risk of developing cancer. A family history of Hodgkin’s lymphoma or a past infection with Epstein-Barr virus, human T-cell lymphotropic virus, or human immunodeficiency virus (HIV) is also a possible risk factor.

Non-Hodgkin’s

Risk factors for developing non-Hodgkin’s lymphoma include male gender, age over 60, and a family history of non-Hodgkin’s lymphoma. Having a first-degree relative with NHL increases the risk of developing NHL. A past infection with Epstein-Barr virus, human T-cell lymphotropic virus, or human immunodeficiency virus (HIV) can also increase the risk of getting non-Hodgkin’s lymphoma.

Hodgkin’s vs. non-Hodgkin’s risk factors
Hodgkin’s	Non-Hodgkin’s
Male gender Age between 20 and 40 or over 55 Family history of Hodgkin’s lymphoma History of infection with Epstein-Barr virus, human T-cell lymphotropic virus, or human immunodeficiency virus (HIV)	Male gender Age over 60 Family history of non-Hodgkin’s lymphoma History of infection with Epstein-Barr virus, human T-cell lymphotropic virus, or human immunodeficiency virus (HIV)

Prevention

Hodgkin’s

The risk factors for Hodgkin’s lymphoma cannot be changed in most cases. Therefore, there’s no proven way to prevent Hodgkin’s lymphoma. An infection with HIV can increase the risk of developing Hodgkin’s lymphoma. Avoiding unprotected sex and IV drug use can reduce the risk of HIV infection.

Non-Hodgkin’s

Risk factors for non-Hodgkin’s lymphoma cannot be changed. Therefore, there is no sure way to prevent non-Hodgkin’s lymphoma. Preventing infection with HIV may help reduce the risk of developing non-Hodgkin’s lymphoma.

How to prevent Hodgkin’s vs. non-Hodgkin’s
Hodgkin’s	Non-Hodgkin’s
No known way to prevent Hodgkin’s lymphoma Taking preventative action against HIV infection may help reduce the risk of developing Hodgkin’s lymphoma	No known way to prevent non-Hodgkin’s lymphoma Taking preventative action against HIV infection may help reduce the risk of developing non-Hodgkin’s lymphoma

When to see a doctor for Hodgkin’s or non-Hodgkin’s

If you’re experiencing any potential signs or symptoms of cancer, you should see a doctor. Talk to a doctor if you’re experiencing any abnormal changes, like unexplained weight loss, swollen lymph nodes, or heavy night sweats. You may be referred to a doctor who specializes in oncological hematology, or those who study diseases and cancers of the blood. Your healthcare provider can guide you on available treatment options and their uses, administration, and potential side effects.

Frequently asked questions about Hodgkin’s and non-Hodgkin’s

What is the survival rate of Hodgkin’s and non-Hodgkin’s lymphoma?

Overall, Hodgkin’s lymphoma is a highly treatable cancer when caught early with a 5-year survival rate of almost 90%. The 5-year survival rate of non-Hodgkin’s lymphoma is around 72%, according to the American Cancer Society.

Is Hodgkin’s worse than non-Hodgkin’s lymphoma?

The progression of Hodgkin’s lymphoma is typically more predictable than that of non-Hodgkin’s lymphoma. The prognosis of Hodgkin’s lymphoma is also better than that of non-Hodgkin’s lymphoma since non-Hodgkin’s lymphoma is often diagnosed at a more advanced stage. Both forms of blood cancer are treatable when caught early, however.

What type of Hodgkin’s lymphoma or non-Hodgkin’s lymphoma do I have?

There are different forms of lymphomas, and Hodgkin’s lymphoma and non-Hodgkin’s lymphoma can be further broken down into different subtypes. Subtypes of Hodgkin’s lymphoma include nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted classical Hodgkin lymphoma. Subtypes of non-Hodgkin’s lymphoma include diffuse large B-cell lymphoma, Burkitt lymphoma, and mantle cell lymphoma.