Treatments for nodular lymphocyte-predominant Hodgkin lymphoma

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is treated based on the stage. Stage 1 and stage 2 may also be called early NLPHL. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Stage 1 nodular lymphocyte-predominant HL

Treatment for stage 1 NLPHL is radiation therapy or active surveillance.

Either involved site radiation therapy (ISRT) or involved field radiation therapy (IFRT) is often used to treat stage 1 NLPHL. Find out more about radiation therapy for Hodgkin lymphoma.

During active surveillance, the healthcare team watches for any signs and symptoms that mean cancer is progressing (starting to grow or spread). You will begin treatment when you have symptoms.

Stages 2, 3 and 4 nodular lymphocyte-predominant HL

Treatment for stage 2 and stages 3 or 4 (advanced) NLPHL is chemotherapy or a chemotherapy combination, with or without radiation therapy. Some people with minimal stage NLPHL may be treated with radiation alone.

Chemotherapy combinations used to treat stage 2 and advanced disease include:

  • ABVD – doxorubicin, bleomycin, vinblastine and dacarbazine
  • CHOP – cyclophosphamide (Procytox), doxorubicin, vincristine and prednisone
  • CVP – cyclophosphamide, vinblastine and prednisone

The targeted therapy drug rituximab (Rituxan) may be added to any of these combinations.

Find out more about chemotherapy for Hodgkin lymphoma and targeted therapy for Hodgkin lymphoma.

After chemotherapy, IFRT may be given to areas that have cancer. Find out more about radiation therapy for Hodgkin lymphoma

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Talk to your doctor about clinical trials open to people with HL in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • American Cancer Society. Treating Nodular Lymphocyte-Predominant Hodgkin Lymphoma . 2018: Monday, January 14, 2019.
  • Lash, Bradley W. Medscape Reference: Hodgkin Lymphoma Treatment and Management . 2018.
  • Lash, Bradley W. Medscape Reference: Hodgkin Lymphoma Guidelines . 2018: Monday, January 14, 2019.
  • National Cancer Institute. Adult Hodgkin Lymphoma Treatment for Health Professionals (PDQ®). 2015: http://www.cancer.gov/.