Non-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL), also known as non-Hodgkin's lymphoma, is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas.[1] Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness.[1] Other symptoms may include bone pain, chest pain, or itchiness.[1] Some forms are slow-growing while others are fast-growing.[1] Unlike Hodgkin lymphoma, which spreads contiguously, NHL is largely a systemic illness.[6]
Non-Hodgkin lymphoma
Non-Hodgkin disease
Hematology and oncology
65–75 years old[2]
Five-year survival rate 71% (USA)[2]
4.3 million (affected during 2015)[4]
231,400 (2015)[5]
Lymphomas are types of cancer that develop from lymphocytes, a type of white blood cell.[2] Risk factors include poor immune function, autoimmune diseases, Helicobacter pylori infection, hepatitis C, obesity, and Epstein–Barr virus infection.[1][3] The World Health Organization classifies lymphomas into five major groups, including one for Hodgkin lymphoma.[7] Within the four groups for NHL are over 60 specific types of lymphoma.[8][9] Diagnosis is by examination of a bone marrow or lymph node biopsy.[1] Medical imaging is done to help with cancer staging.[1]
Treatment depends on whether the lymphoma is slow- or fast-growing and if it is in one area or many areas.[1] Treatments may include chemotherapy, radiation, immunotherapy, targeted therapy, stem-cell transplantation, surgery, or watchful waiting.[1] If the blood becomes overly thick due to high numbers of antibodies, plasmapheresis may be used.[1] Radiation and some chemotherapy, however, increase the risk of other cancers, heart disease, or nerve problems over the subsequent decades.[1]
In 2015, about 4.3 million people had non-Hodgkin lymphoma, and 231,400 (5.4%) died.[4][5] In the United States, 2.1% of people are affected at some point in their life.[2] The most common age of diagnosis is between 65 and 75 years old.[2] The five-year survival rate in the United States is 71%.[2]
Signs and symptoms[edit]
The signs and symptoms of non-Hodgkin lymphoma vary depending upon its location within the body. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness. Other symptoms may include bone pain, chest pain, or itchiness. Some forms are slow growing, while others are fast growing.[1] Enlarged lymph nodes may cause lumps to be felt under the skin when they are close to the surface of the body. Lymphomas in the skin may also result in lumps, which are commonly itchy, red, or purple. Lymphomas in the brain can cause weakness, seizures, problems with thinking, and personality changes.[10]
While an association between non-Hodgkin lymphoma and endometriosis has been described,[11] these associations are tentative.[12]
History[edit]
While consensus was rapidly reached on the classification of Hodgkin lymphoma, there remained a large group of very different diseases requiring further classification. The Rappaport classification, proposed by Henry Rappaport in 1956 and 1966, became the first widely accepted classification of lymphomas other than Hodgkin. Following its publication in 1982, the Working Formulation became the standard classification for this group of diseases. It introduced the term non-Hodgkin lymphoma or NHL and defined three grades of lymphoma.
NHL consists of many different conditions that have little in common with each other. They are grouped by their aggressiveness. Less aggressive non-Hodgkin lymphomas are compatible with a long survival while more aggressive non-Hodgkin lymphomas can be rapidly fatal without treatment. Without further narrowing, the label is of limited usefulness for people or doctors. The subtypes of lymphoma are listed there.
Nevertheless the Working Formulation and the NHL category continue to be used by many. To this day, lymphoma statistics are compiled as Hodgkin's versus non-Hodgkin lymphomas by major cancer agencies, including the US National Cancer Institute in its SEER program, the Canadian Cancer Society and the IARC.