Non-Hodgkin’s Lymphoma

 

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 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, in a group of lymph nodes, or in 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 replace the normal cells in the bone marrow. This causes bleeding problems and infections. As the lymphoma cells spread, the body becomes less and less able to produce blood cells that carry oxygen to other tissues or to protect itself from infection.

Non-Hodgkin’s lymphoma is different from Hodgkin’s lymphoma and occurs about eight times more often.

Are there different types of non-Hodgkin’s lymphoma?

Over the years, experts have used a variety of terms to classify the many different types of non-Hodgkin’s lymphoma. 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 referred to as 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 (Revised European-American Lymphoma [REAL] and World Health Organization [WHO]) have revised the classification of lymphoma.

What causes non-Hodgkin’s lymphoma?

The cause of non-Hodgkin’s lymphoma is unknown. The incidence of NHL has continued to increase over the years. It is probably a genetic disorder and may require a “trigger,” such as exposure to something in the environment, to develop. NHL is not contagious.

• NHL is more common in men than in women.
• The likelihood of getting NHL increases as you get older.
• NHL is most common among those who have an inherited immune deficiency, an autoimmune disease, or HIV; it also occurs among those who take medications that impair the immune system following an organ transplant.
• Viral infections, such as with human T-lymphotropic virus type I (HTLV-1) and Epstein-Barr virus, increases the risk of developing NHL.
• Exposure to pesticides, solvents, or fertilizers increases the risk of developing NHL.

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.

How is non-Hodgkin’s lymphoma diagnosed?

Once NHL is suspected, a piece of tissue (biopsy) must be obtained to confirm the diagnosis. Occasionally this can 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 stage of the disease, the grade of the disease, and your age and general health. The four treatment options available are:

• Watchful waiting (surveillance).
• Radiation therapy.
• Chemotherapy.
• Biological therapy.