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
  • R-CHOP – rituximab (Rituxan and biosimilars), cyclophosphamide (Procytox), doxorubicin, vincristine and prednisone
  • R-CVP – rituximab, cyclophosphamide, vinblastine and prednisone

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

  • Guideline Resource Unit (GURU). Lymphoma. Edmonton: Alberta Health Services; 2023: Clinical Practice Guideline LYHE-002 Version: 18. https://www.albertahealthservices.ca/info/cancerguidelines.aspx.
  • 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.
  • PDQ Adult Treatment Editorial Board. Hodgkin Lymphoma Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2023: https://www.cancer.gov/.
  • Hodgkin lymphoma. Site Group: Lymphoma. Princess Margaret Cancer Program Clinical Practice Guidelines. University Health Network; 2021: https://www.uhn.ca/PrincessMargaret/Health_Professionals/Programs_Departments/Pages/default.aspx.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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