An Overview of Non-Hodgkin Lymphoma
Easy bruising or bleeding
Fever, night sweats, or unexplained weight loss
Systemic symptoms that come from inflammation, or “B” symptoms, sometimes occur in NHL and include unexplained fever, drenching night sweats, and unintentional weight loss greater than 10 percent of normal body weight over six months. B symptoms are no longer routinely used in the staging system for NHL because such symptoms tend not to provide independent information about your prognosis.1
The cause of most lymphomas is not known; however, scientists have gained tremendous ground in understanding the role of certain genes in certain types of NHL in the last 15 years, and newer, targeted therapies have emerged as a result.
Additionally, a number of risk factors for NHL are known, including advanced age, having a weakened immune system, certain autoimmune diseases, certain infections, and exposures to radiation, certain chemicals or certain drugs.
While personal and family medical history may be relevant, NHL is not diagnosed by symptoms or history alone. A number of tests are used to diagnose non-Hodgkin’s lymphoma, including the following:
microscopic, molecular and genetic characteristics. For example, diffuse large B-cell lymphoma, follicular lymphoma, and peripheral T-cell lymphoma are three different types of NHL, and each has important differences in the factors that are used to try to determine the prognosis, or prognostic index.3
An individual’s age and overall health, as well as whether or not the lymphoma is confined to or outside the lymph nodes (extra-nodal), also are factors in the prognosis. While the number and location of disease spots in the body (which are important in Lugano staging) do not necessarily shape the prognosis, the total amount of NHL, or tumor burden, can be an important factor in prognosis and treatment.
Across the different types of NHL, what the pathologist describes as a high-grade or intermediate-grade lymphoma usually grows fast in the body, so these two types are considered aggressive NHL. In contrast, low-grade NHL grows slowly, and these lymphomas are therefore called indolent NHL. Compared with aggressive NHLs, indolent NHLs typically do not give rise to too many symptoms, but they also may be harder to eradicate and are less likely to be cured. The most common kind of indolent lymphoma is follicular lymphoma.
A small subset of indolent lymphomas such as follicular lymphoma transforms into aggressive lymphomas over time.
The right treatment for an individual with NHL depends not only on the disease, itself, but also on the person being treated and their age, overall health, preferences, and goals for treatment.
When the lymphoma appears to be slow-growing, or indolent, sometimes a period of no treatment, or watch and wait, may be an option. Indolent lymphomas that are not causing any signs or symptoms may not require treatment for years. When watch and wait is an option, it is usually because data show that, for your particular disease, at your stage of the journey, it is just as good, if not better, to hold off on treatment and its potential side effects than to start immediately– and that waiting doesn’t sacrifice your long-term outcomes.
Today, a number of agents are available to treat NHL, and they may be used alone or in combination, depending on the circumstances. Any number of the following may be a component of a treatment regimen for NHL.