Understanding Hodgkin Lymphoma: Stages

What “Stages” Mean

How does the doctor determine the risk of my disease:

Once you are diagnosed with Hodgkin lymphoma, your doctor will determine your stage, and your IPSS, or International Prognostic Score.

The stage of Hodgkin lymphoma cancer depends on the size of the cancer, lymph node involvement and if there is any spread of the tumor to other areas of the body. It helps your doctor plan the right course of treatment.

To determine the stage of Hodgkin lymphoma, your doctor will consider:

  • Whether the lymph nodes are on one or both sides of your diaphragm.
  • Whether the disease has spread to your bone marrow, spleen, liver, or lung.

The stages of Hodgkin lymphoma are:

Stage 1

This is a very early stage. The lymphoma cells are in one lymph node group (such as the neck or underarm). Or the lymphoma cells may be in only one part of a tissue or organ (like the lungs).

Stage 2

The lymphoma cells are in at least 2 lymph node groups on the same side of the diaphragm. They may be either above or below the diaphragm but must be on the same side. Stage II also applies to lymphoma cells that are in one part of an organ or tissue and the lymph nodes near that organ.

Stage 3

In Stage 3, the lymphoma cells are in lymph nodes above and below the diaphragm. Lymphoma may also be found in one part of a tissue or organ (such as the liver or lungs) that is near these lymph node groups.

Stage 4

In Stage 4, lymphoma cells are found in several parts of one or more organs or tissues.


The disease returns after treatment.

Besides using these staging numbers, your doctor may also classify your Hodgkin lymphoma as either A or B:

  • A: You have not had weight loss, drenching night sweats, or fevers.
  • B: You have had weight loss, drenching night sweats, or fevers.

Usually after staging, your doctor will determine your IPSS score. The IPSS Score for Hodgkin lymphoma is based on 7 factors, including:

  • Age
  • Gender
  • Stage
  • Albumin level in blood (determined by blood test
  • Red blood cell count
  • White blood cell count
  • Lymphocyte count (types of white blood cells, T cells and B cells, that are part of your immune system)

You IPSS score is calculated by adding up how many of these factors are abnormal in your particular case.  This score is the most accurate reflection of your risk, and might persuade your doctor to use one treatment over another.

Next: I have the diagnosis. What’s next? 

Return to "Hodgkin Lymphoma: An Introduction."