Hodgkin lymphoma is a type of cancer that originates in the lymphatic system, which is part of the body’s immune system. While many people with Hodgkin lymphoma respond well to treatment, the disease and its therapies can lead to a variety of complications that affect different parts of the body and overall health.
One major category of complications arises from the lymphoma itself. As the cancerous lymph nodes grow, they can press on nearby organs and tissues, causing symptoms like difficulty breathing if the lymph nodes in the chest enlarge, or problems swallowing if nodes near the throat are affected. The spread of Hodgkin lymphoma beyond lymph nodes to organs such as the liver, spleen, or bone marrow can impair their function, leading to symptoms like fatigue, anemia, or increased risk of infections.
The immune system is often compromised in Hodgkin lymphoma. The disease can cause immune dysfunction, making patients more vulnerable to infections. Sometimes, the lymphoma triggers autoimmune complications, where the immune system mistakenly attacks the body’s own cells. For example, immune thrombocytopenia, a condition where the immune system destroys platelets leading to bleeding problems like nosebleeds or bruising, can rarely occur as a secondary complication. This immune-related issue is uncommon but important to recognize because it requires specific management alongside lymphoma treatment.
Treatment for Hodgkin lymphoma, which often includes chemotherapy and radiation, can also cause significant complications. Chemotherapy drugs can damage healthy cells, leading to side effects such as low blood counts (anemia, neutropenia, thrombocytopenia), which increase the risk of infections, bleeding, and fatigue. Radiation therapy, especially when directed at the chest, can increase the risk of heart and lung problems later in life. Both chemotherapy and radiation raise the risk of developing secondary cancers years after treatment, such as leukemia or other solid tumors.
Long-term complications are particularly relevant for younger patients, including teens and young adults, who often have excellent survival rates but face risks from treatment side effects that can affect their quality of life decades later. These include cardiovascular disease, infertility, hormonal imbalances, and secondary malignancies. For women, Hodgkin lymphoma and its treatment may cause menstrual irregularities, pelvic discomfort, or reproductive health issues.
Another complication involves the systemic symptoms known as “B symptoms,” which include unexplained fever, night sweats, and weight loss. These symptoms reflect the body’s response to the lymphoma and can indicate more advanced disease or a more aggressive course, potentially complicating treatment and recovery.
In some cases, Hodgkin lymphoma can cause swelling of the spleen (splenomegaly) or liver (hepatomegaly), which can lead to abdominal discomfort or impaired organ function. Bone marrow involvement can cause cytopenias, reducing the body’s ability to produce healthy blood cells.
Rarely, Hodgkin lymphoma can involve the nervous system, causing neurological symptoms if cancer cells infiltrate the brain or spinal cord, or paraneoplastic syndromes where the immune response to the lymphoma affects nerves.
Overall, the complications of Hodgkin lymphoma are diverse, ranging from direct effects of tumor growth and spread, immune system dysfunction, treatment-related toxicities, to long-term health risks. Managing these complications requires careful monitoring, supportive care, and sometimes additional treatments to address specific issues like infections, bleeding, or organ dysfunction. Early detection and treatment of Hodgkin lymphoma improve outcomes and help reduce the severity of these complications.
