Treating Nodular Lymphocytic Predominant Hodgkin Lymphoma (NLPHL)

Because this rare type of Hodgkin lymphoma (HL) tends to grow more slowly than classic HL, it is sometimes treated slightly differently.

In people with early stage NLPHL without any B symptoms, radiation therapy alone is often all that is needed.An option for some people might be to have the lymphoma watched closely at first, and then start treatment only when symptoms appear.

If early-stage NLPHL is bulky (large) or is causing B symptoms, the main treatment is usually chemotherapy followed by radiation therapy. Many doctors use the ABVD chemo regimen, although some doctors prefer others. The monoclonal antibody rituximab (Rituxan) might be given along with the chemotherapy

If the lymphoma is more advanced (stage III or IV), chemotherapy, with or without radiation therapy and/or the monoclonal antibody rituximab (Rituxan), is likely to be recommended. Many doctors use the ABVD chemo regimen, although some doctors prefer others. Some patients without B symptoms might be given rituximab alone.

The treatment information given here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about your treatment options. 


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Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Bartlett NL, Foyil KV. Chapter 105: Hodgkin lymphoma. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa. Elsevier: 2014.

National Cancer Institute. Physician Data Query (PDQ). Adult Hodgkin Lymphoma Treatment. 2016. Accessed at on April 20, 2016.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Hodgkin Lymphoma. Version 2.2016. Accessed at on April 20, 2016.

Younes A, Carbone A, Johnson P, Dabaja B, Ansell S, Kuruvilla J. Chapter 102: Hodgkin’s lymphoma. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.

Last Medical Review: February 10, 2017 Last Revised: March 29, 2017

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