Hodgkin lymphoma (HL) — sometimes called Hodgkin’s disease — is a form of blood cancer that originates from a specific type of white blood cells called lymphocytes. In a person living with HL, Reed-Sternberg cells — a type of abnormal lymphocyte — grow within the lymphatic system, a part of the immune system that helps prevent and fight infections. HL can start in a person’s lymph nodes (groups of tissue that contain lymphocytes), bone marrow (the soft tissue found within certain bones), or organs of the lymphatic system, such as the spleen or thymus.
It’s not usually clear why any one person develops HL. However, experts understand how individual cells can become cancerous and have identified risk factors that can increase a person’s chances of developing Hodgkin lymphoma.
Like other types of cancer, HL is caused by changes in a cell’s genes. Genes are like sets of instructions that help cells work correctly. When these genes are changed or mutated, the cells start behaving abnormally. They may grow too quickly, ignore signals to slow down or die, or fail to heal accumulating damage.
Once lymphocytes develop gene changes, they may grow out of control. Cancerous lymphocytes often collect within lymph nodes or other lymph tissue, forming tumors. They crowd out normal lymphocytes, which makes it harder for the body to fight off future infections.
Researchers don’t know the exact cause of HL — they haven’t discovered exactly why cancerous gene changes develop. However, they have found certain risk factors that may make it more likely that a cell’s genes will undergo changes.
Risk factors are elements that make a person more likely to develop a condition. In some cases, researchers know why a particular risk factor leads to a higher risk of HL. In other cases, it’s not clear. Having one of these risk factors does not necessarily mean a person will be diagnosed with lymphoma, but it does elevate risk.
Adolescents, young adults, and the elderly are most at risk for developing Hodgkin lymphoma. A person’s risk is highest from age 15 to age 40. People over the age of 55 begin to have an elevated risk.
Males develop most types of HL at slightly higher rates than females, according to Cancet.Net. However, one type of Hodgkin lymphoma called nodular sclerosis occurs more often in women.
People in the United States, Canada, and Europe develop HL more often than people who live in other parts of the world. Rates of HL are lowest in Africa and Asia.
People who have a higher socioeconomic status (are more wealthy) are more likely to be diagnosed with HL. Experts don’t know the reason for this.
HL does not usually run in families. However, in rare cases, multiple members of the same family develop Hodgkin lymphoma. People who have a sibling or parent with HL have a slightly higher chance of being diagnosed with this condition.
A person has an increased risk of HL if their immune system is not very strong. Those who have had an organ transplant may take immunosuppressant medications that make the immune system less effective. This increases HL risk. Children who have had an organ transplant are 19 times more likely to develop HL than children who have not undergone this procedure.
Up to one in four people with HL have cancer cells that are infected with Epstein-Barr virus (EBV). EBV is the virus that causes mononucleosis or mono. Researchers don’t know how this virus can lead to HL. It’s possible that EBV causes gene changes within lymphocytes. It’s also possible that HL develops when the immune system has an abnormal reaction to an EBV infection.
Almost all adults within the U.S. have had EBV infections. Doctors aren’t yet sure why EBV leads to HL in only a small portion of infected individuals.
Most HL risk factors, such as age and family history, can’t be changed. This means that most people can’t prevent lymphoma or change their risk level.
One risk factor that a person has a little more control over is HIV infection. Lowering your chances of coming into contact with HIV may also reduce your risk of developing lymphoma. You can help prevent HIV infection by using protection during sex and avoiding sharing needles or other drug-related equipment.
If you are worried about your lymphoma risk, talk to your doctor. They may be able to explain your risk and help you learn more about whether you can reduce your chances of developing Hodgkin lymphoma.
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