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Non-Hodgkin's lymphoma - Highlights

Description

An in-depth report on the causes, diagnosis, and treatment of non-Hodgkin's lymphoma.

Alternative Names

Lymphoma - non-Hodgkin's; NHL; B-cell lymphomas

Highlights:

Non-Hodgkinâ ' s Lymphoma

The non-Hodgkinâ ' s lymphomas (NHL) are a group of cancers that develop in the bodyâ ' s lymphatic system. There are many different types of non-Hodgkinâ ' s lymphoma. Most types of NHL involve B cells, while a small percentage involve T cells. Common types of B-cell non-Hodgkinâ ' s lymphomas include diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma.

Prognosis

Non-Hodgkinâ ' s lymphomas are classified as indolent (slow-growing) or aggressive (fast-growing). Aggressive lymphomas, such as DLBCL, are often curable. Indolent lymphomas, such as follicular lymphoma, are more difficult to treat and tend to recur after periods of remission. With the advancement of new treatments and drugs, survival rates for patients with NHL have significantly improved.

Risk Factors

The risk of NHL increases with age, and most patients are diagnosed when they are in their 60s and 70s. NHL can develop, however, in people of any age, including children. People who have had immune system impairment through infections, disease, or exposure to certain types of chemicals appear to have increased risk. Still, people without any known risk factors can develop NHL.

Symptoms

The most common first sign of lymphomas is painless enlargement of one or more lymph node, usually in the neck, armpits, or groin.

More generalized symptoms can include:

  • Drenching night sweats
  • Unexplained weight loss
  • Fever
  • Severe itching

Diagnosis

NHL is diagnosed based on the results of physical examination, blood tests, imaging tests, and biopsy. A lymph node biopsy is the definitive test for diagnosing NHL, determining the type of NHL, and distinguishing NHL from Hodgkinâ ' s disease.

Treatment

Radiation and chemotherapy are the main treatments for NHL. Rituximab, a biologic drug, is increasingly being used and may be added to a chemotherapy regimen. For some patients, stem cell or bone marrow transplantation may be an option.

Resources

References

Armitage JO, Wyndham HW. Non-Hodgkin’s lymphoma. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 112.

Boffetta P, de Vocht F. Occupation and the risk of non-Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev. 2007: 16(3):369-72.

Cheson BD, Leonard JP. Monoclonal antibody therapy for B-cell non-Hodgkin's lymphoma. N Engl J Med. 2008 Aug 7;359(6):613-26.

Ferrara JL. Novel strategies for the treatment and diagnosis of graft-versus-host-disease. Best Pract Res Clin Haematol. 2007. 20(1):91-7.

Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007 Feb 10;25(5):571-8. Epub 2007 Jan 22.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin’s Lymphoma. V.1.2009.

Oeffinger KC, Ford JS, Moskowitz CS, Diller LR, Hudson MM, Chou JF, et al. Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA. 2009 Jan 28;301(4):404-14.

Pulte D, Gondos A, Brenner H. Ongoing improvement in outcomes for patients diagnosed as having Non-Hodgkin lymphoma from the 1990s to the early 21st century. Arch Intern Med. 2008 Mar 10;168(5):469-76.

Seam P, Juweid ME, Cheson BD. The role of FDG-PET scans in patients with lymphoma. Blood. 2007 Nov 15;110(10):3507-16. Epub 2007 Aug 20.

  • Reviewed last on: 3/5/2009
  • Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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