Non-Hodgkin Lymphoma Facts

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What is non-Hodgkin lymphoma?

Non-Hodgkin lymphoma (NHL) is a type of blood cancer that begins in the lymphatic system. This system is part of the body’s immune system. It helps fight infections and rids the body of toxins and other substances. Specifically, NHL affects a kind of white blood cell called a lymphocyte. As abnormal lymphocytes grow and multiply, they clog the lymphatic system and cause tumors.

Non-Hodgkin lymphoma is one of the two major types of lymphoma. Hodgkin lymphoma (or Hodgkin’s disease) is the other, but it is less common than NHL. Because it is the more common of the two major types, NHL may be referred to simply as lymphoma.

What are the different types of non-Hodgkin lymphoma?

Non-Hodgkin lymphoma includes more than 60 subtypes. Doctors classify them by the type of lymphocyte (such as B cells or T cells) and how quickly or slowly they grow:

  • Aggressive NHL grows and spreads quickly. About 60% of NHL cases are aggressive. The most common aggressive NHL in the United States is diffuse large B-cell lymphoma (DLBCL). Doctors usually recommend treating these lymphomas right away.

  • Indolent NHL grows and spreads slowly and may not require immediate treatment. These lymphomas account for the other 40% of cases. In the United States, follicular lymphoma (FL) is the most common subtype.

The cancer cell’s appearance, presence of specific proteins, and genetic features also contribute to the classification.

Who gets non-Hodgkin lymphoma?

NHL accounts for about 4% of all new cancer cases each year in the United States. More than 74,000 Americans will get NHL this year, which ranks it the 7th most common cancer in the United States. It is the most common blood cancer in adults.

The most recent data for the United States also shows:

  • More than 50% of cases occur in people 65 years and older, while about 2% are younger than 20.

  • NHL is one of the most common cancers in children, accounting for 5% of childhood cancers.

  • Men are more likely than women to get NHL.It is 2 to 3 times more common in boys than girls.

  • NHL is more common in people of Caucasian descent compared to Hispanic or African American descent.

Can you die from non-Hodgkin lymphoma?

Non-Hodgkin lymphoma life expectancy depends on the specific type of NHL and the stage at the time it was diagnosed. For adults, doctors often talk about survival in terms of a 5-year relative survival rate. This rate looks at people with the same type and stage of cancer five years after diagnosis. It compares them to people of the same age and sex in the general population. The comparison shows how much cancer can shorten life. For NHL, the overall 5-year relative survival rate is 72%. However, survival rates with follicular lymphoma tend to be higher. Children also tend to have a higher survival rate.

Non-Hodgkin lymphoma prognosis has been improving over the last 10 years. The mortality rate has been falling by 2.2% each year. New cases have also been falling by 0.9% per year. Still, nearly 20,000 Americans will die of NHL this year.

How does non-Hodgkin lymphoma affect quality of life?

Health-related quality of life (HRQoL) describes how a disease affects a person’s overall well-being. It includes mental, physical and emotional health. It also includes the ability to engage socially and perform daily functions and roles. Non-health factors, such as finances, can play a role in HRQoL too.

With non-Hodgkin lymphoma, HRQoL can change with time. It’s common for NHL patients to have periods when symptoms are worse and periods when they improve. However, researchers have identified some trends in NHL HRQoL:

  • HRQoL improves as the years pass after diagnosis. However, it can dip around five years after diagnosis, possibly related to anxiety at this milestone.

  • Even long-term, 15-year survivors can be fearful of recurrence. This is true regardless of NHL stage at diagnosis.

  • Most NHL survivors report a lack of social support. This makes it more likely that HRQoL will be low.

  • Those with financial difficulties at diagnosis are more likely to report a lack of social support.

  • Treatment type plays a role in long-term HRQoL.

Understanding HRQoL issues can help doctors and other healthcare providers better care for NHL patients and survivors. Connecting patients with others and addressing financial problems may improve HRQoL in NHL.

What causes non-Hodgkin lymphoma?

Cancer develops when cells grow out of control. There are two types of genes that manage cell growth—oncogenes and tumor suppressor genes. Oncogenes help cells grow. Tumor suppressor genes make cells die when they should. Mutations or changes in either of these types of genes can lead to cancer. Sometimes, these mutations are passed from parent to child. Other times, people develop or acquire them over the course of their lifetime.

Having a family history of lymphoma increases the risk of developing it. However, scientists believe NHL gene mutations are usually acquired, not inherited. This explains why the risk increases with age and most cases occur in older people. Factors that increase the risk of acquiring these mutations include:

  • Autoimmune diseases and immune system deficiencies

  • Certain infections, including HIV, Epstein-Barr virus, and human T-cell lymphotropic virus

  • Chemotherapy for other cancers

  • Exposure to certain chemicals including benzene and ingredients in herbicides and pesticides

  • Radiation exposure including environmental exposures and from radiation therapy for previous cancer

How are you diagnosed with non-Hodgkin lymphoma?

Sometimes, non-Hodgkin lymphoma does not cause symptoms. Doctors may find the problem when testing for another medical condition. However, many people seek medical care when they notice a problem, such as persistently swollen lymph nodes or night sweats. When symptoms suggest NHL could be possible, doctors will run tests including:

  • Blood tests to rule out infection or other causes

  • Imaging exams to look for tumors in the lymphatic system

  • Biopsies to look at the cells in the lymph node(s)

Once doctors have diagnosed NHL, a bone marrow biopsy may be necessary. This test can help them determine the stage of cancer. This information will guide treatment options.

How is non-Hodgkin lymphoma treated?

Slow-growing NHL may not require immediate treatment. Watchful waiting to monitor the disease may be all that is necessary. However, aggressive NHL usually requires treatment right away.

Non-Hodgkin lymphoma treatment options include chemotherapy, immunotherapy, radiation therapy, targeted therapy, and stem cell transplant. Surgery is not a common treatment.

Additional non-Hodgkin lymphoma facts

Nearly 1 million Americans are living with non-Hodgkin lymphoma or in remission from it. September is National Blood Cancer Awareness Month, which includes lymphoma and leukemia, and September 15 is World Lymphoma Awareness Day. While lime green is a traditional awareness color for non-Hodgkin lymphoma, many buildings and landmarks will light up red on September 15 for blood cancer awareness.

Learn more about non-Hodgkin lymphoma and how to get involved at the Leukemia and Lymphoma Society and the American Cancer Society.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Aug 12
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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