Key takeaways
- Non-Hodgkin lymphoma is a cancer that starts in white blood cells and comprises about 4% of all cancer cases in the United States.
- There are many types of non-Hodgkin lymphoma, classified by whether they originate in B cells or T cells and how quickly they grow.
- Treatment options include chemotherapy, radiation, immunotherapy, and targeted cell therapies, often used in combination depending on the lymphoma’s type and stage, as well as the patient’s overall health.
According to the
It can develop at any age and is common in children and young adults. However, the risk increases as a person ages, and more than half of those with the disease are 65 or older when they receive the diagnosis.
Non-Hodgkin lymphoma is more common in males — about 1 in 44 develop it, while the disease occurs in about 1 in 54 females.
This article explains non-Hodgkin lymphoma and outlines its types, symptoms, and treatment options. It also examines the latest statistics regarding a person’s outlook.
Non-Hodgkin and Hodgkin are the two main types of lymphoma.
Lymphomas are cancers that begin in white blood cells called lymphocytes. These cells are a part of the lymphatic system, which is part of the immune system.
As well as helping the body fight infections and disease, the lymphatic system helps drain excess fluid from tissues and supports the movement of immune cells throughout the body.
Lymphoma can develop in any area of the body that contains lymph tissue, including the:
- lymph nodes, which are located throughout the body — in the chest, abdomen, and pelvis, for example
- spleen, which creates lymphocytes and other immune cells
- bone marrow, where new blood cells form
- thymus, a gland in the upper chest that plays a role in developing lymphocytes
- adenoids and tonsils, which fight against infection in the back of the throat
- digestive tract, as some areas contain lymph tissues
Without treatment, non-Hodgkin lymphoma can spread throughout the body, typically through the lymphatic system. In some cases, cancerous white blood cells may also travel through the bloodstream to reach other organs.
There are many types of non-Hodgkin lymphoma. They fall into two main groups, based on whether the affected white blood cells are B cells or T cells.
Doctors also classify lymphomas based on how fast they grow. Any type can be slow growing (indolent) or fast growing (aggressive).
B cell types
According to the Cancer Support Community, around 85% of non-Hodgkin lymphoma cases in the United States start in B cells. Below are the two most common subtypes.
Diffuse large B-cell lymphoma
Around 1 in 3 cases of non-Hodgkin lymphoma are this type. It usually starts as a lump in a lymph node.
Sometimes, diffuse large B-cell lymphoma starts in the intestine, bone, brain, or spinal cord. It grows quickly but usually responds well to treatment.
Follicular lymphoma
Almost 20% of lymphomas in the United States are this type, which starts in the lymph nodes and bone marrow.
Follicular lymphoma usually grows slowly and responds to treatment, but it is difficult to cure and may come back.
Other B-cell non-Hodgkin lymphoma:
- mucosa-associated lymphatic tissue lymphoma
- small cell lymphocytic lymphoma, or chronic lymphocytic leukemia
- intravascular large B-cell lymphoma
- mantle cell lymphoma
- Burkitt’s lymphoma
- hairy cell leukemia
- primary central nervous system lymphoma
- mediastinal (thymic) large B-cell lymphoma
- lymphoplasmacytic lymphoma, or Waldenstrom macroglobulinemia
- nodal marginal zone B cell lymphoma
- splenic marginal zone lymphoma
- extranodal marginal zone B-cell lymphoma
- primary effusion lymphoma
T cell types
The Cancer Support Community reports that T cell types account for fewer than 15% of all non-Hodgkin lymphoma cases in the United States. Subtypes include:
- Peripheral T-cell lymphoma: Also known as generic T-cell lymphoma, this is the most common type of T-cell lymphoma, and there is a range of further subtypes.
- Cutaneous T-cell lymphoma: This type includes T-cell lymphomas that primarily affect the skin, but they can also affect the blood, lymph nodes, and internal organs.
Other types of lymphoma that affect the T cells include:
- anaplastic large cell lymphoma
- angioimmunoblastic T-cell lymphoma
The symptoms of non-Hodgkin lymphoma often depend on the specific type and where it is in the body.
Some people experience no symptoms before the cancer has become advanced.
Common symptoms of non-Hodgkin lymphoma
- enlarged lymph nodes
- fever and chills
- a swollen belly
- feeling full after eating very little
- bruising easily
- shortness of breath
- a cough
- frequent infections
- unexplained weight loss
- fatigue
A person may also experience B symptoms, such as a fever that comes and goes or severe night sweats.
The symptoms of cutaneous T-cell lymphoma tend to include enlarged lymph nodes, dry skin, itching, and a red or discolored rash.
A biopsy is the only way to diagnose non-Hodgkin lymphoma. This means removing a small sample of tissue, usually from a lymph node, to check for cancer.
A doctor called a pathologist looks at the sample under a microscope to see if it contains cancer cells and to determine what type of lymphoma it is.
Staging
After making a diagnosis of non-Hodgkin lymphoma, the doctor will perform a number of tests to see how far the cancer has progressed. Healthcare providers refer to this process as staging.
Staging may involve imaging tests, such as X-rays or MRI scans.
The healthcare team may also perform blood tests, bone marrow biopsies, or heart and lung function tests.
There are four stages of non-Hodgkin lymphoma. Stage 1 is the least advanced, while stage 4 is the most advanced. The
There are four main types of treatment for non-Hodgkin lymphoma: chemotherapy, radiation therapy, immunotherapy, and targeted cell therapies.
Often, healthcare professionals recommend a combination of treatments. Their approach depends on a number of factors, including:
- the type and stage of the lymphoma
- the person’s overall health and fitness levels
The medical community does not know what causes non-Hodgkin lymphoma, but a number of factors make it more likely to develop.
The risk factors for non-Hodgkin lymphoma include:
- older age, as most people diagnosed are
65 or older - sex, as those assigned male at birth are slightly more likely to develop the disease than those assigned female
- excess body weight and an unhealthy diet
- certain bacterial infections, such as Helicobacter pylori
- viral infections, such as HIV or Epstein-Barr virus (EBV)
- autoimmune disorders, including rheumatoid arthritis or lupus
- a history of organ transplants
- previous cancer treatments, such as chemotherapy or radiation
- radiation exposure
- immunodeficiency disorders, such as stage 3 HIV
Receiving a diagnosis can cause concern. The term “5-year survival rate” refers to the percentage of people who live for at least 5 years after receiving a diagnosis.
The overall 5-year relative survival rate for non-Hodgkin lymphoma is
However, it is important to remember that this figure is based on averages. This means that, on average, people with non-Hodgkin lymphoma are 74% as likely as those without the disease to be alive 5 years after their diagnosis.
Individual outcomes can vary based on factors such as the lymphoma’s subtype, stage at diagnosis, age, and overall health.
A person’s outlook depends on the type and stage of the cancer, among other factors. A doctor can provide more detailed information based on factors specific to each person.