What is non-Hodgkin's lymphoma?
Non-Hodgkin's lymphoma (NHL) is cancer of the cells of the lymphatic system. In non-Hodgkin's lymphoma, cells in the lymphatic system either divide and grow without order or control, or old cells do not die as cells normally do. Non-Hodgkin's lymphoma can start almost anywhere in the body. It may occur in a single lymph node, a group of lymph nodes, or an organ such as the spleen. Non-Hodgkin's lymphoma can spread to almost any part of the body, including the liver, bone marrow, and spleen.
Over time, lymphoma cells may replace the normal cells in the bone marrow. Bone marrow failure results in the inability to produce red blood cells that carry oxygen, white blood cells that fight infection, and platelets that stop bleeding.
Non-Hodgkin's lymphoma is different from Hodgkin's lymphoma and occurs about 8 times more often.
Are there different types of non-Hodgkin's lymphoma?
There are many different types of non-Hodgkin's lymphoma. Over the years, experts have used a variety of terms to classify these different types. Most often, they are grouped by how the cancer cells look under a microscope and how quickly they are likely to grow and spread. Aggressive lymphomas, also known as intermediate- and high-grade lymphomas, tend to grow and spread quickly and cause severe symptoms. Nonaggressive lymphomas, also called indolent or low-grade lymphomas, tend to grow quite slowly and cause fewer symptoms early in the disease course.
In an effort to increase the understanding of lymphoma and standardize treatment, experts in Europe and North America have revised the classification of lymphoma (Revised European-American Lymphoma Classification [REAL], published by the World Health Organization [WHO]).
What causes non-Hodgkin's lymphoma?
The cause of non-Hodgkin's lymphoma is not known. The incidence of NHL has continued to increase over the years. When a person has non-Hodgkin's lymphoma, abnormal rapid cell growth occurs. This abnormal growth may be triggered by an infection or exposure to something in the environment. Non-Hodgkin's lymphoma is not contagious.
Non-Hodgkin's lymphoma is more common in men than in women.
The likelihood of getting non-Hodgkin's lymphoma increases as you get older.
Non-Hodgkin's lymphoma is most common among those who have an inherited immune deficiency, an autoimmune disease, or HIV. It also occurs among those who take medicines that impair the immune system following an organ transplant.
Viral infections, such as with human T-lymphotropic virus type I (HTLV-1), hepatitis C, and Epstein-Barr virus, increases the risk of developing non-Hodgkin's lymphoma.
Exposure to pesticides, solvents, or fertilizers increases the risk of developing non-Hodgkin's lymphoma.
What are the symptoms?
The most common symptom of non-Hodgkin's lymphoma is a painless swelling of the lymph nodes in the neck, underarm, or groin. Other symptoms may include:
Unexplained fever.
Night sweats.
Extreme fatigue.
Unexplained weight loss.
Itchy skin.
Reddened patches on the skin.
Cough or shortness of breath.
Pain in the abdomen or back.
How is non-Hodgkin's lymphoma diagnosed?
When non-Hodgkin's lymphoma is suspected, a piece of tissue (biopsy) is needed to confirm the diagnosis. This can sometimes be done by inserting a needle into a lymph node, but usually the entire lymph node must be removed. The piece of tissue is then analyzed under a microscope by a pathologist to see whether NHL is present.
How is it treated?
Treatment of non-Hodgkin's lymphoma depends on the type of lymphoma, the stage of the disease, and your age and general health. The treatment options are:
Watchful waiting (surveillance).
Radiation therapy.
Chemotherapy.
Monoclonal antibody therapy.
Stem cell transplant plus chemotherapy.
Not all of these options are appropriate for all types of non-Hodgkin's lymphoma.
