Mixed Cellularity Hodgkin Lymphoma: Signs, Prognosis, and More

Mixed cellularity Hodgkin lymphoma is a type of Hodgkin disease, a cancer of lymph cells. It is the second most common type of classical Hodgkin disease. About 15% to 30% of all individuals with Hodgkin lymphoma in the western world have this type.

The most common symptom of mixed cellularity Hodgkin lymphoma is swollen but painless lymph nodes in the neck, armpits, or groin. Other possible symptoms include itching throughout the body, and drenching night sweats. Hodgkin disease is one of the most curable forms of cancer.

This article discusses causes and symptoms of mixed cellularity Hodgkin lymphoma, along with how it is diagnosed and treated.

What Is Mixed Cellularity Hodgkin Lymphoma?

Mixed cellularity Hodgkin lymphoma is a cancer of the lymphatic system, characterized by abnormal cells in lymph nodes.

In mixed cellularity Hodgkin lymphoma, the lymph nodes contain a mixture of large, abnormal lymphocytes (white blood cells) called Reed-Sternberg cells, which are a hallmark of Hodgkin lymphoma. The lymph nodes also contain other cell types, which is why it's called "mixed cellularity."

Mixed cellularity Hodgkin can occur at any age, although it is most common in children and adults ages 50 and above. It is slightly more common in males, and people who have an immune system that is functioning poorly, for example, in people with HIV. 

What Causes Mixed Cellularity Hodgkin Lymphoma?

It's not known what causes Hodgkin disease, though some risk factors have been identified. 

With mixed cellularity type lymphoma there is a high incidence of Epstein-Barr present in the cancer cells, but scientists are still uncertain of the exact relationship between lymphomas and this virus which causes infectious mononucleosis.

Telltale Symptoms of Hodgkin Lymphoma

The main symptoms of Hodgkin lymphoma are:

• Painless, swollen lymph nodes in the neck, underarm, or groin
• Fever
• Drenching night sweats
• Dramatic weight loss for no known reason
• Itchy skin
• Feeling very tired even after a full night's sleep

Tests and Diagnosis

The diagnosis of lymphoma is made with:

• Physical exam
• Lymph node biopsy
• Blood tests
• Bone marrow biopsy
• Imaging tests

These tests may also be used to determine:

• The specific type of lymphoma
• How advanced the lymphoma is
• What treatments will be most effective and tolerable

Treatment

Many individuals with this lymphoma are diagnosed with advanced stage disease, involving lymph nodes on both in the upper part of the body and in the abdomen.

For people with early-stage disease, treatment usually involves a combination of chemotherapy and radiation therapy.

With advanced stage disease, treatments often consist of prolonged chemotherapy and are less likely to involve the use of radiation therapy. 

For those who have a relapse of mixed cellularity Hodgkin lymphoma, or if initial treatment fails, there are several options. One is to use salvage chemotherapy (chemotherapy used to decrease the volume of a tumor but not cure the cancer) followed by high dose chemotherapy and autologous stem cell transplant. 

Other options may include the use of the monoclonal antibody Blincyto (brentuximab), immunotherapy with a checkpoint inhibitor, a nonmyeloablative stem cell transplant, or a clinical trial.

Prognosis for Hodgkin Lymphoma in Mixed Cellularity

Though mixed cellularity Hodgkin lymphoma is an aggressive cancer, the prognosis is very good. It is roughly the same as people who have nodular sclerosing Hodgkin lymphoma, and better than for people who have lymphocyte depletion Hodgkin disease.

Coping

No matter the prognosis, it's terrifying to be diagnosed with cancer, In addition to that, treatments to put this type of Hodgkin disease into remission can be very challenging and taxing, and we are learning that stress is not a good idea for people with lymphomas. Reach out to family and friends. Consider joining a support group in your community or online.

Summary

Mixed cellularity Hodgkin lymphoma is a common (but still rare) type of Hodgkin lymphoma that most often occurs in children and adults ages 50 and up. Symptoms usually include swollen but painless lymph nodes in the neck, underarms, and groin, but one might also experience other symptoms, like drenching night sweats and excessive itching.

Treatment for mixed cellularity Hodgkin lymphoma may involve a combination of chemotherapy, radiation therapy, and immunotherapy. Even though it's considered an aggressive cancer, the prognosis for mixed cellularity Hodgkin lymphoma is good.