Non-Hodgkin Lymphoma

Lymphoma comprises more than 67 subtypes of two related cancers that affect the lymphatic system, Hodgkin lymphoma (formerly referred to as Hodgkin's lymphoma) and non-Hodgkin lymphoma (NHL) (formerly referred to as non-Hodgkin's lymphoma). There are six types of Hodgkin lymphoma and at least 61 types of non-Hodgkin lymphoma. Non-Hodgkin lymphomas are different from Hodgkin lymphomas in the way they develop, spread and are treated. Lymphoma is the most common blood cancer and the third most common cancer among children. For information on a specific sub-type of NHL, click here.

What Is Non-Hodgkin Lymphoma?

NHL is the most common cancer of the lymphatic system. Since the early 1970's, incidence rates for non-Hodgkin lymphoma have nearly doubled. Over the 25-year period between 1973 and 1998, new cases of NHL seen each year escalated almost 83%, among the highest increases of any cancer. The overall five-year survival rate is only 63%. Of the nearly 500,000 Americans with lymphoma, 332,000 have this form. In 2009, it is estimated that 65,980 new cases of NHL will be diagnosed and 19,500 Americans will die from the disease.

NHL is not a single disease, but rather a group of several closely related cancers that affect the lymphatic system, which is part of the immune system.

NHL is broadly divided into two major groups: B-cell lymphoma (which develops from abnormal B-lymphocytes, which is most common), and T-cell lymphomas (which develop from abnormal T-lymphocytes). Lymphocytes are a type of white blood cell that helps the body fight infections. B-cells develop into plasma cells that produce antibodies to fight infections, while T-cells attack foreign invaders (bacteria, viruses, etc.) directly.

How Do Non-Hodgkin Lymphomas Develop?

NHL can start in the lymph nodes, in a specialized lymphatic organ such as the spleen, or in lymph tissue found in organs such as the stomach or intestines.  Since lymphocytes (white blood cells) can circulate to all parts of the body through the lymphatic vessels and bloodstream, abnormal lymphocytes can reach any part of the body.  Thus, NHL can start in or spread to any part of the body. While some NHLs are localized to one area, most are present in other parts of the body by the time the diagnosis is confirmed.

What Are The Warning Signs?

While most people who have these complaints will not have NHL, anyone with persistent symptoms should be seen by a doctor to make sure that lymphoma is not present: chills, swelling of the lymph nodes (which are often but not always painless), fever, night sweats, unexplained weight loss, lack of energy, and itching.

What Are The Risk Factors?

The causes of non-Hodgkin lymphoma remain unknown, but immune system impairment and exposure to environmental carcinogens, pesticides, herbicides, viruses, and bacteria may play a role. There may be a higher risk for getting NHL in individuals:

• With a family history of NHL (though no hereditary pattern has been well established)
• Affected with autoimmune disease
• Who have received an organ transplant
• Exposed to chemicals such as pesticides, fertilizers, or solvents
• Infected with viruses such as Epstein-Barr, human T-lymphotropic virus type 1, HIV, hepatitis C, or certain bacteria, such as H-pylori

How Is NHL Treated?

While many effective treatment options exist, low grades of NHL usually recur, and some people go in and out of remission for years.  In certain patients with indolent disease, treatment may not be necessary until there are signs of progression, and response to treatment can change over time.  Treatment that worked initially may be ineffective the next time, making it necessary to always keep abreast of the latest information on new or experimental treatment options. 

However, 30%-60% of patients with aggressive NHL can be cured. Although the indolent forms of NHL are not currently curable, the prognosis is still very good, and patients may live for 20 years or more. Many people treated for NHL will receive some form of chemotherapy, radiation therapy, biologic therapy, or a combination of these. Bone marrow or stem cell transplantation may sometimes be used. Surgery may be used under special circumstances, but primarily to obtain a biopsy for diagnostic purposes.

What’s New In Research?

Lymphoma is often called the "Rosetta Stone" of cancer research because it has helped unlock the mysteries of several other types of cancer.  The Lymphoma Research Foundation funds some of the most cutting-edge research to find a cure for non-Hodgkin lymphoma.  Some promising research areas are:

• New antibody treatments, which act like guided missiles that zero in on specific targets (antigens) on the lymphoma cells
• Vaccine treatments to stimulate the immune system to attack the lymphoma
• Profiling tumors by examining the finger-print-like pattern expressed by genes, thus aiding in prognosis and development of new treatments
• Testing new therapies that are biologically targeted to unique abnormalities specific to certain lymphomas

For more information click - Understanding Non-Hodgkin's Lymphoma - A Guide For Patients

For more information, call 1-800-500-9976, e-mail helpline@lymphoma.org, or continue to visit www.lymphoma.org.