Overview of Mixed Cellularity Hodgkin Lymphoma

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Mixed cellularity Hodgkin’s lymphoma is a type of Hodgkin disease, a cancer of lymph cells. It is the second most common type of classical Hodgkin disease, and about 15 to 30 percent of all individuals suffering from Hodgkin lymphoma in the western world have this type. The proportion of patients with this type of Hodgkin is higher in parts of the world outside of the United States, including Asia. In some populations, it is the most common type of Hodgkin lymphoma.

Doctor palpating a patients Lymph Nodes
Universal Images Group / Getty Images


Mixed cellularity Hodgkin can occur at any age, although it is most common in adults between the ages of 55 and 74, as well as children under the age of 14. It is equally common in men and women. The rate of this type of lymphoma appears to have decreased in incidence between 1992 and 2011, but this may be due to the way that lymphomas are classified instead of a true decrease in incidence.

It is more common in people who have an immune system that is functioning poorly, for example, in people with HIV.


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.


The main symptoms of mixed cellularity disease are enlarged lymph nodes in the neck, armpits and the abdomen.

Other organs are less likely to be involved with this form of lymphoma than some other types of lymphoma. With mixed cellularity disease 30 percent of people have involvement of their spleen, 10 percent their bone marrow, 3 percent their liver, and only 1 to 3 percent of people have involvement of other organs.


The diagnosis of lymphoma is made with a lymph node biopsy.


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. Chemotherapy protocols are discussed in this article on the treatment of Hodgkin lymphoma.

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.


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.


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.

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By Indranil Mallick, MD
 Indranil Mallick, MD, DNB, is a radiation oncologist with a special interest in lymphoma.