Understanding Non-Hodgkin Lymphoma (NHL): Causes, Symptoms, and Management

What is it?

Non-Hodgkin lymphoma (NHL) is a type of cancer that develops in the lymphatic system. The cells of the lymphatic system, called lymphocytes, are responsible for fighting infections, and are located along the lymphatic ducts and organs (which are the lymph nodes, bone marrow, spleen and thymus). In Non-Hodgkin's lymphoma, abnormal lymphocytes grow out of control, fill the lymphatic system and may spread beyond it.
Non-Hodgkin's lymphoma is the most common type of cancer of the lymphatic system. There are many different subtypes of non-Hodgkin's lymphoma, each grows and spreads at different rates. Non-Hodgkin’s lymphomas are divided to indolent or aggressive. Indolent lymphoma, the most common of which is follicular lymphoma, tends to grow and spread slowly. Aggressive lymphoma, the most common of which is diffuse large B cell lymphoma, grows and spreads quickly, and has signs and symptoms that can be severe. The treatments for indolent and aggressive lymphoma are different.
The chances of recovery from non-Hodgkin lymphoma (the prognosis) depend on the stage of the disease (how much it spread), as well as on age, functional status, and various laboratory criteria. In general, aggressive lymphomas are life-threatening but curable, whereas indolent lymphomas are less dangerous and may have a chronic nature.
Non-Hodgkin lymphoma is most common in people 60 or over. Risk factors for non-Hodgkin lymphoma include older age, being male, and having a weakened immune system.

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Additional names

This group contains additional names:
- Sezary's Disease
- Leukemic Reticuloendotheliosis
- Hairy cell leukemia
- Malignant Mast Cell Tumors of Unspecified Site- Extranodal and Solid Organ Sites
- Nodular Lymphoma
- Malignant Histiocytosis
- Peripheral T Cell Lymphoma

Signs & symptoms

Symptoms of non-Hodgkin lymphoma usually include painless swelling of lymph nodes (located in the neck, armpits or groin), abdominal pain or swelling, fever, drenching night sweats, unexplained weight loss and persistent fatigue. When fever, drenching night sweats, and weight loss occur together, this group of symptoms is called B symptoms.

Diagnosis

If your doctor suspects that you have non-Hodgkin's lymphoma based on your medical history, a description of the various symptoms and a complete physical examination, he will ask for additional tests:
- Blood tests.
- Lymph node biopsy, in which all or part of a lymph node is removed and a viewed under a microscope to look for cancer cells.
- Imaging tests, such as CT, MRI or PET-CT. These tests will be performed if a non-Hodgkin's lymphoma diagnosis has been made, and their purpose is to identify the cancer location and whether it has spread.
- Bone marrow test, which will be necessary if there is a suspicion of the disease spreading to the bone marrow. In this test, a sample of bone marrow is taken using a needle inserted into the hipbone or another bone.

Treatment

There are different types of treatment for patients with non-Hodgkin's lymphoma. The type, duration of treatment, and combination of treatments depend on the particular type of non-Hodgkin's lymphoma and the stage of the disease.
Indolent lymphomas that don't cause signs and symptoms may not require treatment for years, and will only be monitored. In other cases, treatment options include:
- Chemotherapy: treatment that kills quickly growing cells, A characteristic feature of cancer cells. Systemic combination chemotherapy is used for the treatment of non-Hodgkin lymphoma. Intrathecal chemotherapy (administered into the spinal canal or brain) may also be used in some cases, as CNS prophylaxis (aimed to lessen the chance that lymphoma cells will spread to the brain and spinal cord).
- Radiation therapy: treatment that uses high-energy x-rays to kill cancer cells.
- Bone marrow transplant: - treatment in which healthy marrow from a donor is transplanted and creates new healthy blood cells instead of cancerous cells.
- Biological therapy: including targeted therapy (treatment that targets cancer cells specifically using its biological characteristics) and immunotherapy (treatment that activates the immune system to fight cancer cells).
- Surgery: in some cases, a surgery called splenectomy (removing of the spleen) will be needed.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital