Non-Hodgkin’s lymphoma, or NHL, is a disease in which malignant (cancerous) cells form in the lymph system, which is part of the immune system.1 It is one of the most common blood cancers among adults in the U.S.2
How NHL Starts
NHL occurs when too many abnormal lymphocytes, a type of white blood cell, are produced.3
Normally, old lymphocytes die, and the body creates new ones to replace them. In people with NHL these lymphocytes don’t die, but continue to grow and divide. This oversupply of lymphocytes crowds into lymph nodes, causing them to swell.3
85% of NHL cases start in lymphocytes called B-cells.4
A small percentage of cases start in lymphocytes called T-cells.4
NHL by the Numbers
ESTIMATED NEW CASES IN THE U.S. IN 20176
MEDIAN AGE AT DIAGNOSIS6
Categories of NHL
NHL is grouped into two categories based on growth rate: indolent (slow-growing) and aggressive (fast-growing).1
FOLLICULAR LYMPHOMA (FL)
is the most common type of indolent NHL.7
DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL)
is the most common type of aggressive NHL.7
Signs and Symptoms of NHL 3,8
The most common symptom is swollen lymph nodes, which can often be felt as lumps under the skin.
Symptoms of NHL may be seen in other conditions as well. Only a doctor will be able to tell if the symptoms are related to NHL.
SWOLLEN, PAINLESS LYMPH NODES
in neck, armpits or groin
trouble breathing or chest pain
or feeling of fullness in abdomen
UNEXPLAINED WEIGHT LOSS
SOAKING NIGHT SWEATS
PERSISTENT WEAKNESS AND TIREDNESS
Treatment of NHL1,7
Treatment approach is dependent on a variety of factors, including the type of NHL, growth rate and stage.
For Indolent NHL:
Doctors may recommend a “watch and wait” or observational approach until disease progression for some people who do not show any symptoms.7
This form of NHL is incurable and relapse is common. A goal of treatment is controlling the disease.9
For Aggressive NHL:
Doctors typically begin treatment immediately without an observational period.7
For most patients a goal is to achieve remission or control the disease if it does return.10,11
Treatment Options Include:
BONE MARROW OR STEM CELL TRANSPLANT
OTHER TARGETED AGENTS
1 National Cancer Institute. Adult Non-Hodgkin Lymphoma Treatment (PDQ®).
http://www.cancer.gov/types/lymphoma/patient/adult-nhl-treatment-pdq. Accessed July 28, 2017.
2 National Cancer Institute. A Snapshot of Lymphoma. http://www.cancer.gov/research/progress/snapshots/lymphoma. Accessed July 28, 2017.
3 National Cancer Institute. What You Need to Know About Non-Hodgkin Lymphoma. http://www.cancer.gov/publications/patient-education/non-hodgkin-lymphoma.pdf. Accessed July 28, 2017.
4 Harris N.L, Stein H, Coupland S.E, et al. New approaches to lymphoma diagnosis. Haematology January 1, 2001; DOI:
5 Swerdlow S.H., Campo E., Harris N.L., Jaffe E.S., Pileri S.A., Stein H., Thiele J., Vardiman J.W. (Eds.): WHO Classification
of Tumors of Haematopoetic and Lymphoid Tissues. IARC: Lyon 2008.
6 National Cancer Institute. SEER Cancer Statistics Factsheets: Non-Hodgkin Lymphoma.
http://seer.cancer.gov/statfacts/html/nhl.html. Accessed July 28, 2017.
7 National Cancer Institute. Adult Non-Hodgkin Lymphoma Treatment – for health professionals (PDQ®).
http://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq#section/all. Accessed June 24, 2016.
8 Evans L.S., Hancock B.W. Non hodgkin lymphoma. The Lancet. July 12, 2013; DOI: 10.1016/S0140-6736(03)
9 Ghielmini, M., Follicular Lymphoma. Ann Oncol. October 2010;DOI:10.10963/annonc/mdq287.
10 Morrison et al., Approach to therapy of diffuse large B-cell lymphoma in the elderly: the International Society of Geriatric
Oncology (SIOG) expert position commentary. Annals of Oncology. February 24, 2015; DOI:10.1093/annonc/mdv018.
11 Shipp, M. et. al., A Predictive Model for Aggressive Non-Hodgkin’s Lymphoma: The International Non-Hodgkin’s
Lymphoma Prognostic Factors Project. N Engl J Med. September 30, 1993; DOI: 10.1056/NEJM199309303291402.