Lymphoma (Hodgkin & Non-Hodgkin): Latest Treatment Options in India

Lymphoma is one of the most treatable forms of cancer—especially when detected early and managed with the right treatment approach. With the rapid progress in hematology and oncology, patients in India today have access to world-class diagnostic tools, precision medicines, and highly advanced therapies such as Immunotherapy, Targeted Therapy, and Bone Marrow Transplant.

In this comprehensive guide, we break down the causes, symptoms, diagnosis, and latest treatment options available for Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL), drawing insights from the clinical expertise of Dr. Rahul Bhargava, one of the most trusted lymphoma specialists in India.

What Is Lymphoma?

Lymphoma is a type of blood cancer that begins in the lymphatic system, which is part of the body’s immune system. This network includes lymph nodes, spleen, bone marrow, tonsils, and thymus gland.

When lymphocytes (a type of white blood cell) grow abnormally, they form tumors in lymph nodes and may spread to other organs.

Lymphoma is broadly divided into two major types:

1. Hodgkin Lymphoma (HL)

Hodgkin Lymphoma is marked by the presence of Reed-Sternberg cells—large abnormal lymphocytes seen under a microscope.

Key Features of Hodgkin Lymphoma:

• Most common in young adults (15–40 years) and older adults (55+).
   
• Highly treatable, even in advanced stages.
   
• Survival rates are very high with modern treatment.

2. Non-Hodgkin Lymphoma (NHL)

NHL refers to a large group of lymphomas (80+ subtypes). These vary from slow-growing (indolent) to aggressive types.

Common Types of NHL:

• Diffuse Large B-Cell Lymphoma (DLBCL) – most common type
• Follicular Lymphoma
• Mantle Cell Lymphoma
• T-Cell Lymphomas
• Burkitt Lymphoma

NHL requires specialized treatment plans based on the subtype, stage, age, and patient health—areas where specialists like Dr. Rahul Bhargava have deep expertise.

Causes & Risk Factors of Lymphoma

While the exact cause remains unknown, several factors may increase risk:

Family history of lymphoma

Weakened immune system

(e.g., HIV, organ transplant patients on immunosuppressants)

Autoimmune diseases

Such as lupus, rheumatoid arthritis

Exposure to certain chemicals

Pesticides, herbicides, solvents

Viral infections

EBV (Epstein–Barr Virus), Hepatitis B/C, HTLV-1

Increasing age

Risk increases with age (mostly in NHL)
Lymphoma often develops without obvious risk factors, so awareness and early screening are important.

Symptoms of Lymphoma

Symptoms depend on the affected body part but common warning signs include:

Lymph Node–Related Symptoms:

• Swollen, painless lymph nodes in neck, armpit, or groin
• Feeling of pressure or fullness

General Symptoms:

• Unexplained weight loss
• Persistent fatigue
• Fever without infection
• Night sweats (soaking)
• Loss of appetite
• Itchy skin

Organ-Specific Symptoms:

• Chest pain / shortness of breath (if nodes in chest)
• Abdominal pain or swelling
• Recurrent infections

If these symptoms persist, an evaluation by a hematologist is essential.

How Lymphoma Is Diagnosed

Diagnosis involves multiple steps so doctors can correctly identify the lymphoma subtype:

1. Physical Examination

Checking swollen lymph nodes, spleen, or liver.

2. Blood Tests

• CBC (Complete Blood Count)
• LDH levels
• ESR
• Liver and kidney function

3. Imaging Tests

• PET-CT Scan is the gold standard to detect lymphoma activity and spread.
• CT Scan of neck, chest, abdomen, pelvis.

4. Lymph Node Biopsy

The most reliable test. Tissue is removed and examined under a microscope to confirm lymphoma and identify subtype.

5. Bone Marrow Biopsy

Checks if lymphoma has reached the bone marrow.

6. Immunohistochemistry (IHC)

Helps classify lymphoma into specific subtypes.

7. Genetic & Molecular Tests

Identify chromosomal abnormalities and guide targeted therapy.

Stages of Lymphoma

Lymphoma is staged based on how far it has spread:

• Stage I: One lymph node region
• Stage II: Two or more lymph node regions on the same side of the diaphragm
• Stage III: Lymph nodes on both sides of diaphragm
• Stage IV: Spread to organs like bone marrow, liver, lungs

The stage helps determine treatment intensity.

Latest Treatment Options for Lymphoma in India

Advances in hematology and oncology have dramatically improved cure rates for HL and NHL. Below are the most effective and advanced treatments, widely used by experts like Dr. Rahul Bhargava.

1. Chemotherapy (Primary Treatment)

Chemotherapy remains the cornerstone for both Hodgkin and Non-Hodgkin Lymphoma.

Hodgkin Lymphoma:

• ABVD regimen – gold standard
  (Adriamycin, Bleomycin, Vinblastine, Dacarbazine)

• Escalated BEACOPP for advanced cases

Non-Hodgkin Lymphoma:

• R-CHOP regimen for DLBCL
  (Rituximab + Cyclophosphamide + Doxorubicin + Vincristine + Prednisolone)

Chemotherapy is often combined with targeted therapy or immunotherapy, depending on the lymphoma subtype.

2. Immunotherapy – A Major Breakthrough

Immunotherapy boosts the body’s immune system to fight lymphoma cells.

For Hodgkin Lymphoma:

• Nivolumab (PD-1 inhibitor)
• Pembrolizumab

These are highly effective in relapsed and refractory Hodgkin lymphoma.

For Non-Hodgkin Lymphoma:

• CAR-T Cell Therapy (Revolutionary treatment)

  • Currently available in India
  • Personalized immune cells engineered to kill lymphoma cells
• Monoclonal antibodies like Rituximab, Obinutuzumab
• Bispecific antibodies (newest option)

Immunotherapy has dramatically improved survival rates and quality of life for lymphoma patients.

3. Targeted Therapy

Targeted drugs act on specific genetic changes in lymphoma cells.

Commonly used targeted therapies in India include:

• Ibrutinib (BTK inhibitor)
• Acalabrutinib
• Lenalidomide
• Venetoclax
• Idelalisib
• Copanlisib

These are especially useful for:

• Relapsed or refractory NHL
• Mantle cell lymphoma
• Follicular lymphoma
• CLL/SLL with lymphoma features

Targeted therapy is transforming lymphoma care due to higher precision and fewer side effects.

4. Radiation Therapy

Radiation therapy is often used for:

• Early-stage Hodgkin lymphoma
• Localized Non-Hodgkin lymphoma
• Residual disease after chemotherapy

Modern radiation techniques like IMRT, IGRT, and Proton Therapy provide high precision with minimal side effects.

5. Bone Marrow Transplant (BMT)

One of the most effective treatments for aggressive or relapsed lymphoma.

Types of BMT performed by specialists like Dr. Rahul Bhargava:

Autologous Bone Marrow Transplant (Auto BMT)

• Patient’s own stem cells used
• Recommended for relapsed HL and NHL
• High success rates
• Lower complications

Allogeneic Bone Marrow Transplant (Allo BMT)

• Donor stem cells used
• Effective for high-risk or aggressive lymphoma
• Helpful when lymphoma has returned multiple times

Dr. Rahul Bhargava is known for pioneering and successfully performing thousands of bone marrow transplants in India, improving survival outcomes significantly.

6. CAR-T Cell Therapy – The Future of Lymphoma Treatment

CAR-T Cell Therapy is considered a game changer for relapsed or refractory lymphoma.

How it works:

• Patient’s T-cells are extracted
• Genetically modified to attack cancer cells
• Re-infused to destroy lymphoma cells

Benefits:

• High success in resistant lymphoma
• One-time treatment
• Long-lasting response

India has recently introduced this advanced therapy at selected centers.

7. Watchful Waiting (For Slow-Growing NHL)

For indolent lymphomas like Follicular Lymphoma, immediate treatment may not be needed if symptoms are absent.
Regular monitoring ensures early action if the disease progresses.

Survival Rates and Prognosis

Thanks to modern treatments, the outlook for lymphoma patients has improved greatly.

Hodgkin Lymphoma:

• Cure rate: 85–95%, especially in early stages
• Long-term remission is common

Non-Hodgkin Lymphoma:

Depends on subtype, stage, and overall health, but treatment outcomes continue to improve every year.

Lifestyle, Diet & Supportive Care

Patients benefit from:

• Healthy, high-protein diet
• Infection control measures
• Regular exercise (as tolerated)
• Emotional and mental health support
• Vaccinations (as recommended post-treatment)

Supportive care is an essential part of recovery and long-term health.

Expert Insights – Dr. Rahul Bhargava

Dr. Rahul Bhargava, one of India’s foremost hematologists, emphasizes:

“Lymphoma is highly treatable when managed with the right diagnosis, molecular profiling, and evidence-based therapies. With advanced options like immunotherapy, targeted treatment, and bone marrow transplant, we are achieving better survival and improved quality of life for patients.”

He focuses on:

• Accurate subtyping through biopsy + molecular tests
• Personalized treatment plans
• Minimizing toxicity
• Advanced BMT protocols
• Long-term follow-up and survivorship care

Conclusion

Lymphoma—both Hodgkin and Non-Hodgkin—is one of the most curable cancers today. With the right diagnosis, timely treatment, and expert care from specialists like Dr. Rahul Bhargava, patients can expect excellent outcomes.

Modern therapies such as Targeted Drugs, Immunotherapy, CAR-T Cell Therapy, and Bone Marrow Transplant have transformed the treatment landscape in India.

If you or a loved one has symptoms or a confirmed diagnosis of lymphoma, early consultation with a hematologist is essential to ensure the best possible prognosis.