Non-Hodgkin Lymphoma

There are over 60 types of lymphomas which are usually divided into Hodgkin’s (accounts for around 10%) and Non-Hodgkin Lymphoma (NHL) (accounts for around 90%).  Lymphomas are blood cancers which develop from white cells called lymphocytes and there are 2 types of lymphocytes namely B-cells and T-cells.   

Common Signs & Symptoms of NHL are vague & non-specific (which makes it difficult to diagnose). They include;

• Enlarged lymph nodes
• Fever & night sweats
• Unexplained weight loss
• Fatigue and tiredness
• Itchiness (in the absence of any skin lesions)
• Bone pain
• Bruise or bleed easily
• Frequent infections

Investigations to Diagnose NHL include;

• Blood tests to look at the number and morphology of red and white blood cells
• Bone Marrow Biopsy
• Gene Expression Profiling
• Lymph node biopsy to look at the cell type to determine the type of lymphoma
• Imaging tests like chest X-ray, CT / MRI scan or PET scan (to determine the stage of the lymphoma)

Staging of Lymphoma

Staging of the disease is important because it allows your doctor to know the extent of the disease and plan your treatment as well as understanding your prognosis and outcome of treatment.  Each stage can be sub-divided into A (where you have NO symptoms) or B (where you have symptoms of fever, night sweats or weight loss greater than 10%)

What are the Different Cell Types of NHL

There are many different types of NHL and the most recent WHO classification is based on the following criteria;

• The type of lymphocyte (either B-cells or T-cells) involved
• Histopathology of the lymphoma
• Chromosome features of the lymphoma cells
• Presence of certain proteins on the cancer cells

NHL are also given specific names like;

• T-Cell Lymphoma
• B-Cell Lymphoma
• Diffuse Large B-Cell Lymphoma
• Follicular Small Cell Lymphoma

NHL can spread to other parts of the lymphatic system if not treated, and eventually it can spread to other parts of the body such as the liver, brain or bone marrow.

Treatment of NHL

Treatment options for NHL depend on the type and stage of the lymphoma.  Chemotherapy and immunotherapy are most commonly used while radiotherapy may be used in certain circumstances.  Your haematologist or cancer specialist will be able to discuss the treatment options with you.

Before starting treatment, you may consider sperm banking or egg freezing to protect your fertility opportunity if you want to start a family later in life.  This is because the chemotherapy may reduce your chances of getting pregnant naturally.

The chemotherapy is given in cycles (usually 6-8 cycles) consisting of a treatment period followed by a period of rest to allow the body time to recover. Each chemotherapy cycle usually lasts for several weeks. Most chemo treatments are given on an outpatient basis (daycare) but some might require an overnight hospital stay. 

Follow-up Schedule

Upon completing your treatment, it is IMPORTANT that you have regular follow-up to monitor your blood counts every 3-6 months or as directed by your doctor.

Prognosis

The 5-year survival and treatment outcome depends on many factors such as;

• Type of lymphoma
• Cell type of disease
• Stage of the disease
• Your age
• Your fitness and activity level
• Any other medical condition which you have

See a Haematologist or Cancer Specialist to discuss your Treatment Options

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Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

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