Hematology: Hodgkin vs. Non-Hodgkin Lymphomas

General information

Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma are two types of cancer associated with white blood cells. These diseases majorly affect the immune system of a human organism because of their effect on lymphocyte cells (Cheson et al., 2014). Although their common places of origin and negative effects result in similar symptoms experienced by patients, there are a number of differences between these two types of lymphoma.

It is also important to point out that the definition of whether white cells are affected by Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma can only be made after an analysis conducted by a doctor. In order to define the type of lymphoma, it is required to make a biopsy or other means of analyzing the tumor tissue. In such a way, it is possible to define the type of cancer cells and recognize whether they belong to Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma. Considering that they differ on a cellular level, based on such analysis, the pathology and prognosis of the disease are defined (Armitage & Weisenburger, 1998).

In terms of differences between the abnormal cells typical for both diseases, so-called Reed-Steinberg cells are recognized as a feature characterizing Hodgkin’s lymphoma (Cheson et al., 2014). The pathological analysis is not yet able to identify precisely from which type of lymphocyte cells the disease originates. However, those abnormal neoplastic cells are known to produce metastases in different areas of the human body. On the other hand, in the case of Non-Hodgkin’s lymphoma, the abnormal cells observed are not classified as Reed-Steinberg cells.

Since Hodgkin’s lymphoma was discovered first, any type of lymphoma that does not have Reed-Steinberg cells and originates from lymphoid tissues is considered a Non-Hodgkin’s lymphoma. It makes the analysis of it a lot more difficult and requires various identification procedures in terms of the disease’s cytological, immune, and morphological features (Armitage & Weisenburger, 1998). For that reason, there are some major difficulties and controversies in classifying such lymphomas.

Nursing & medical management of Hodgkin and Non-Hodgkin’s lymphomas

The treatment planning designed for Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma is also quite different. While the former appears to be responsive to chemotherapy, planning for the latter depends, in many ways, on the type of Non-Hodgkin’s lymphoma, but the classifications are quite complex.

In the case of a diagnosis of Non-Hodgkin’s lymphoma, Armitage and Weisenburger (1998) also underline the fact that because “patients will be given these diagnoses by pathologists, it is important that clinicians be knowledgeable with regard to their clinical characteristics” (p. 2780). It is also important to point out that medical management of Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma relies on the constant updates of the histological analysis, a type of lymphoma, a stage of the disease, and a variety of prognostic factors. However, “regardless of stage, general practice is to treat patients based on limited (stages I and II, non-bulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology” (Cheson et al., 2014, p. 3059).

In terms of nursing care planning, it is important to give special consideration to educating both a patient and their family about the nature of the disease, its implications, and a patient’s needs. On one hand, the task of a nurse is to monitor a patient for any adverse reactions to the treatment. However, on the other hand, it is important to help a patient to manage their symptoms that are mostly associated with the effects of Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma on a human body. For example, the abnormality of white blood cells results in various forms of anemia, and the therapy can make a patient nauseous or induce vomiting, etc. (Engert et al., 2010).

References

Armitage, J. O., & Weisenburger, D. D. (1998). New Approach to Classifying Non-Hodgkin’s Lymphomas. Journal of Clinical Oncology, 16(8), 2780-2795.

Cheson, B. D., Fisher, R. I., Barrington, S. F., Cavalli, F., Schwartz, L. H., Zucca, E., & Lister, T. A. (2014). Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and non-Hodgkin Lymphoma: The Lugano Classification. Journal of Clinical Oncology, 32(27), 3059-3067.

Engert, A., Plütschow, A., Eich, H. T., Lohri, A., Dörken, B., Borchmann, P.,… & Debus, J. (2010). Reduced Treatment Intensity in Patients with Early-Stage Hodgkin’s Lymphoma. New England Journal of Medicine, 363(7), 640-652.

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