23 Oct 2018

Hodgkin Lymphoma Above and Below the Diaphragm: Are The Outcomes Different?

This study investigated the development of Hodgkin lymphoma (HL) above and below the diaphragm. Patients with HL above the diaphragm had better survival and response to treatment.

HL is a type of cancer which affects the lymph nodes. HL may develop above or below the diaphragm (a muscle which helps you breathe). Patients with HL below the diaphragm appear to have worse outcomes. However, there has been little research into this. It is important to research HL below the diaphragm.

Two trials which studied HL above and below the diaphragm were analysed. Between 2003 and 2009, 2903 patients with early stage HL were evaluated. Patients were followed for an average of 51 months. The development of HL above or below the diaphragm was monitored. The treatment outcomes were also analysed.


Almost 8% of patients developed HL below the diaphragm. These patients tended to be older. Patients with HL below the diaphragm were also less likely to respond to treatment. Patients with HL above the diaphragm were less likely to experience disease worsening.  In general, they were also more likely to survive. Of the patients with HL below with diaphragm, almost 92% survived and 80% did not experience disease worsening after 5 years. Whereas almost 98% of patients with HL above the diaphragm survived and 91% did not experience disease worsening. Treatment with two cycles of strong chemotherapy improved survival with HL below the diaphragm.

The main finding was that patients with HL above the diaphragm had better survival than those with HL below the diaphragm.