What is Non-Hodgkin Lymphoma?
Non-Hodgkin lymphoma (NHL) is a blood cancer that occurs when specialized white blood cells in the lymphatic system (lymphocytes) undergo harmful mutations that cause them to grow and divide uncontrollably. If left untreated, the cancerous cells may crowd out healthy lymphocytes, which produce antibodies to help the body fight off bacteria, viruses and other harmful invaders. This can weaken the body’s immune system, increasing the risk of infection.
Researchers have identified at least 86 different types of non-Hodgkin lymphoma. Each type can be broadly classified into two groups: B-cell lymphomas, which develop from abnormal B-cell lymphocytes, or T-cell lymphomas, which develop from abnormal T-cell lymphocytes or natural killer (NK) lymphocytes. All types of NHL can be further categorized as either slow-growing (indolent) or fast-growing (aggressive).
Non-Hodgkin lymphoma is relatively common, accounting for approximately 4% of all cancer diagnoses in the United States, and thousands of new cases are diagnosed each year. Although NHL can occur at any age, it predominantly affects older adults.
What causes non-Hodgkin lymphoma?
Scientists continue to explore the possible ways in which NHL develops. In most cases, the precise cause is unknown. Experts believe that a weakened immune system may contribute to its development. Therefore, individuals who take immunosuppressants or have a human immunodeficiency virus (HIV) infection may be at heightened risk and should be especially vigilant for possible warning signs, such as painless lumps under the skin caused by enlarged lymph nodes.
What are the risk factors for non-Hodgkin lymphoma?
In addition to a weakened immune system, other known risk factors for NHL include:
- Advanced age – Most cases are diagnosed after age 60.
- Certain infections – Epstein-Barr virus (EBV), Helicobacter pylori and human T-cell leukemia/lymphotropic virus (HTLV-1) are linked to NHL.
- Exposure to chemicals – Frequent exposure to certain pesticides, herbicides and industrial chemicals may increase the risk of NHL.
- Family history – Individuals with a close relative who was diagnosed with lymphoma are at heightened risk.
- Radiation exposure – Prior radiation therapy for medical treatment can increase the risk of NHL.
How does non-Hodgkin lymphoma affect the body?
NHL causes abnormal growth of lymphocytes, which can accumulate in the lymph nodes, spleen and other lymphatic tissues and cause painless swelling. As the cancer progresses, it may impair the body’s ability to fight off infections and spread to other organs and tissues, such as the liver, lungs and bone marrow. NHL can also affect the gastrointestinal system, skin or central nervous system, leading to organ-specific symptoms such as abdominal pain and neurological issues. The specific effects of non-Hodgkin lymphoma on the body can vary depending on its subtype and stage.
What are the symptoms of non-Hodgkin lymphoma?
Because NHL is a blood cancer that affects the lymphatic system, which extends throughout the body, its symptoms can vary depending on the specific parts of the body affected. In addition to enlarged lymph nodes, possible warning signs include:
- Fever, chills and night sweats
- Unintended weight loss
- Loss of appetite
- Abdominal pain and swelling
- An uncomfortable sensation of fullness (satiety) after eating only a small amount of food
- Pain or pressure in the chest
- Persistent coughing and shortness of breath
- Frequent, severe or prolonged infections
- Easy bleeding and bruising
- Overwhelming fatigue
Rated High Performing in Leukemia, Lymphoma & Myeloma
Schedule an AppointmentHow is non-Hodgkin lymphoma diagnosed?
The diagnostic process for NHL begins with a discussion of the symptoms, a review of the patient’s medical history and a physical examination. After ruling out more common conditions, such as infections and autoimmune disorders, the physician will typically order blood work, urinalysis and imaging scans. If the results suggest cancer, the physician will likely follow up with one or more advanced diagnostic tests, such as:
- Lymph node biopsy
- Bone marrow biopsy
- Lumbar puncture (spinal tap)
- Echocardiogram
- Pulmonary function test
After confirming a diagnosis of non-Hodgkin lymphoma, the physician will usually order additional testing to identify its type, which is an important consideration when planning treatment. Some options include:
- Immunohistochemistry
- Cytogenetic testing
- Fluorescent in situ hybridization (FISH) testing
- Polymerase chain reaction (PCR) testing
How is non-Hodgkin lymphoma treated?
NHL treatment can vary depending on the type and stage of the cancer and other factors. Some options include:
- Chemotherapy – After being administered intravenously or orally, powerful cancer-fighting drugs enter the bloodstream and circulate throughout the body. Because chemotherapy can reach and destroy widespread cancer cells, it is the main form of treatment for NHL, a systemic cancer. Chemo can be effective when used alone or in combination with other therapies.
- Radiation therapy – High-energy beams, such as X-rays or protons, are precisely delivered to a cancerous lymph node or another affected area of the body. Radiation therapy may be used as a standalone treatment for indolent NHL or after chemotherapy to destroy any residual cancer cells.
- Targeted therapy – As researchers gain a deeper understanding of the abnormal changes that cause lymphocytes to grow uncontrollably, they are leveraging this knowledge to develop targeted therapies. One example is the use of proteasome inhibitors, which prevent enzyme complexes (proteasomes) within cells from degrading the proteins that regulate cell division, thereby disrupting the uncontrolled growth of cancerous cells.
- Immunotherapy – To build on the natural cancer-fighting ability of the body’s immune system, scientists are creating man-made antibodies (monoclonal antibodies) that can attack a specific target, such as a unique substance found on the surface of cancerous lymphocytes.
- Bone marrow transplantation – After undergoing high-dose chemotherapy or radiation therapy to destroy the lymphoma cells, the patient receives healthy blood-forming stem cells from a compatible donor.
Benefit from world-class care at Moffitt Cancer Center
NHL is a diverse and complex cancer, and specialized treatment is necessary to ensure the best possible outcome and quality of life. Moffitt’s renowned Malignant Hematology Program is home to a multispecialty team that focuses exclusively on the diagnosis and treatment of Hodgkin and non-Hodgkin lymphomas. Working collaboratively, we develop an individualized treatment plan for each patient and then closely monitor their progress and make treatment adjustments as necessary. In a single location, our patients have access to all aspects of lymphoma diagnosis, treatment and support, including promising new therapies available only through our robust portfolio of clinical trials.
At Moffitt, we remain committed to exploring new and better ways to detect and treat lymphoma. In recognition of our extensive research efforts and groundbreaking achievements, the National Cancer Center designated Moffitt a Comprehensive Cancer Center, and we are the only cancer center based in Florida to have received this prestigious distinction.
If you would like more information about non-Hodgkin lymphoma, you can request an appointment with a specialist at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.
Helpful Links:
