What is Non-Hodgkin's (NHL) lymphoma in simple terms?

Non-Hodgkin's Lymphoma Explained in Simple Terms

Non-Hodgkin's lymphoma (NHL) is a cancer that starts in your immune system cells called lymphocytes, causing them to grow abnormally and form tumors in your lymph nodes and other parts of your body. 1, 2

What is Non-Hodgkin's Lymphoma?

• NHL represents a diverse group of cancers that originate in the lymphatic system, specifically in B-lymphocytes (80-85% of cases), T-lymphocytes (15-20%), or rarely in natural killer (NK) cells 2
• Unlike Hodgkin's lymphoma, NHL lacks the specific Reed-Sternberg cells that characterize Hodgkin's disease 3
• NHL is one of the most common cancers in the United States, ranking as the 6th most frequent cancer diagnosis among men and women 1, 4

Types of Non-Hodgkin's Lymphoma

NHL is divided into many different subtypes based on how the cells look under a microscope and their genetic features:

• B-cell lymphomas (most common, 80-85% of cases) 1, 2

  • Diffuse Large B-Cell Lymphoma (DLBCL) - about 31% of all NHL cases 1
  • Follicular Lymphoma (FL) - about 22% of all NHL cases 1
  • Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia (SLL/CLL) - about 6% 1
  • Mantle Cell Lymphoma (MCL) - about 6% 1
  • MALT Lymphoma - about 5% 1

• T-cell lymphomas (less common, 15-20% of cases) 1, 2

  • Peripheral T-cell Lymphoma (PTCL) - about 6% of all NHL cases 1
  • Other T-cell subtypes are less common 1

How NHL Affects Your Body

• NHL typically starts in the lymph nodes but can begin in almost any part of the body 3
• As abnormal lymphocytes accumulate, they form tumors, primarily in lymph nodes 3
• These cancerous cells can spread through the lymphatic system to other lymph nodes or tissues 3, 5
• In advanced stages, NHL can spread to organs outside the lymphatic system 3

Risk Factors

• Age: NHL risk increases with age, with median age at diagnosis being over 60 years 6
• Weakened immune system: People with HIV/AIDS or those taking immunosuppressive drugs 7
• Autoimmune diseases: Conditions where the immune system attacks the body 5
• Certain infections: Some viral infections may increase risk 5
• In most cases, however, the exact cause remains unknown 5

Symptoms

• Painless swelling of lymph nodes in neck, armpits, or groin 3
• Unexplained fever, night sweats, and weight loss (called "B symptoms") 3
• Fatigue and weakness 3
• Symptoms may vary depending on where the cancer is located in the body 3

Diagnosis and Treatment

• Diagnosis involves biopsy of affected tissue, typically a lymph node 3
• Treatment depends on the specific type of NHL, its stage, and other factors 3, 8
• Common treatments include:
  • Chemotherapy 3, 5
  • Immunotherapy (like rituximab) 5
  • Radiation therapy (especially for localized disease) 8
  • Stem cell transplantation (for aggressive or relapsed disease) 3, 5

Prognosis

• Prognosis varies widely depending on the NHL subtype and stage 3
• Some slow-growing (indolent) types may not require immediate treatment 3
• Aggressive types often respond well to treatment and may be curable 3
• The International Prognostic Index helps predict outcomes 3

NHL is a complex disease with many subtypes, but advances in treatment have significantly improved outcomes for many patients over the past decades 5.