Non-Hodgkin's Lymphoma
What is lymphoma?
Lymphoma is a cancer that begins in cells of the immune system. There are two basic categories of lymphomas: Hodgkin's lymphoma and non-Hodgkin's lymphomas (NHLs), which include a large, diverse group of cancers of immune system cells.
What is non-Hodgkin’s lymphoma (NHL)?
Non-Hodgkin’s lymphoma (NHL) is a disease in which cancer cells form in the lymphatic tissue in the body. Because lymph tissue is found throughout the body, NHL can begin almost anywhere in the body and spread to almost any tissue or organ. There are approximately 30 different types of NHL, which have been divided into two categories: indolent and aggressive. Indolent NHL – Indolent lymphomas are slow-growing lymphomas. The median survival of patients with indolent lymphoma is approximately 10 years. Indolent lymphomas are often responsive to therapy but usually relapse.
Aggressive NHL - Aggressive lymphomas grow faster and typically have a shorter natural history. Treatment of aggressive lymphomas with combination chemotherapy can result in a cure in 30%-60% of patients.
What are the risk factors for NHL?
While the reasons for developing NHL are still unknown, there are some risk factors associated with developing the disease:
- Being an older adult, male or Caucasian
- Having one or more of the following medical conditions
- An inherited immune disorder
- An autoimmune disease
- HIV/AIDS
- Human T-lymphotrophic virus type I or Epstein-Barr virus infection
- A history of Helicobacter pylori infection
- Taking immunosuppressant drugs after an organ transplant
- Being exposed to certain pesticides
- A diet high in meats and fat
- Treated in the past for Hodgkin’s lymphoma.
What are the signs and symptoms of NHL?
Signs and symptoms of NHL vary and may include fever, sweating, excessive fatigue, and weight loss. Additional symptoms can include:
- Swelling in the lymph nodes in the neck, underarm, groin or stomach
- Night sweats
- Loss of appetite/indigestion
- Unexplained pain in the chest, abdomen or bones
How many people are affected by NHL?
The American Cancer Society estimates that 65,980 new cases of NHL were diagnosed in the United States during 2009. About 30-40% of those diagnosed with NHL will have the indolent (or slow-growing) form.
How does a physician determine when to treat for NHL?
Recently, a good deal of progress has been made in the treatment of NHL. Treatment options for patients with NHL depend on the specific kind of lymphoma, its stage, and the patient’s age and general health. Treatments are often tailored to each patient.
What treatment options are currently available for NHL patients?
There are several new investigational therapies being studied in clinical trials. The following are treatment approaches currently used to treat patients with NHL:
- Chemotherapy - drugs used for treating lymphomas that are given as single agents or in combinations. Usually the drugs are given into a vein or by mouth in the form of pills. They can also be injected into the spinal fluid to treat lymphoma cells on the surface of the brain or spinal cord. Once the drugs enter the bloodstream, they spread throughout the body, making this treatment very useful for lymphoma. Chemotherapy may be used alone or along with radiation treatment.
- Biological therapy - uses substances that are made in the laboratory and designed to be similar in nature to those naturally produced by the immune system to fight infection. These substances may kill lymphoma cells, slow their growth, or activate the patient's own immune system to more effectively fight the lymphoma. Commonly used biologics include Interferon and monoclonal antibodies. After years of research, several monoclonal antibodies are now being used as treatments for lymphoma, with more available to treat lymphoma than any other type of cancer. Generally they are used if chemotherapy has failed.