About treatment for Hodgkin lymphoma

The treatment you have will depend on:

  • the type and stage of the lymphoma
  • what symptoms you have
  • the results of your blood tests.
  • which parts of your body are affected
  • your general health
  • your preferences.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can: 

Treating classical Hodgkin lymphoma

If you have early-stage classical Hodgkin lymphoma, you usually have chemotherapy and sometimes steroids, followed by radiotherapy. If the lymphoma is more advanced, chemotherapy is usually the main treatment but you may also have radiotherapy.

If the lymphoma is more advanced, chemotherapy is usually the main treatment. You may also have radiotherapy if there is any lymphoma left after chemotherapy. Radiotherapy may also be given if an area of lymphoma was large (bulky) at diagnosis.

Most people will not need any further treatment to get rid of the lymphoma. However, sometimes lymphoma comes back or there may still be signs of it after treatment. If this happens you might need more treatment.

Treating nodular lymphocyte predominant Hodgkin lymphoma (NLPHL)

If you have nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), your doctor may suggest you delay having treatment. Instead, you have regular appointments and tests to monitor the lymphoma. This is called watch and wait.

If you start treatment, you may have radiotherapy or chemotherapy. Some people have both.  Other people will have a targeted therapy.

Rarely, NLPHL can change into a type of non-Hodgkin lymphoma. If this happens, you will have treatments for non-Hodgkin lymphoma instead.

If the first treatment does not completely work

For most people, their first treatment is very effective and gets rid of all signs of the lymphoma. This is called complete remission. However, in some people, the lymphoma does not completely respond to treatment. This means there are still signs of lymphoma after your treatment is finished.

If this happens, your doctor will talk to you about having different treatment. You may have further treatment that gets the lymphoma into a complete remission. Some people will have treatments that control the lymphoma and treat any symptoms.

You may be treated with further chemotherapy using different drugs. You can also have targeted and immunotherapy drugs.

Some people may have a stem cell transplant using their own stem cells or a donor’s.

Treating Hodgkin lymphoma that has come back

Hodgkin lymphoma can sometimes come back after treatment. This is called a relapse or a recurrence. You will usually have more treatment. Treatment can still work well. This will depend on which treatments you have already had and how quickly the lymphoma has come back. It may also depend on:

  • the type of Hodgkin lymphoma
  • how well you coped with treatment before
  • your general health.

If the lymphoma is not causing any symptoms you may not need to start treatment straight away (watch and wait). You may have further chemotherapy using different and stronger drugs than you had before. Radiotherapy may be used to improve symptoms. Targeted and immunotherapy drugs are often used if the lymphoma comes back. Some people may have a stem cell transplant

About our information

  • References

    Below is a sample of the sources used in our Hodgkin lymphoma (HL) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2018).

    National Institute of Health and Care Excellence (NICE). Blood and bone marrow cancers. NICE Pathways. Last accessed 3 December 2020.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.