Non-Hodgkin lymphoma (NHL)

• Is a type of cancer that affects the lymphatic system
• Generally develops in the lymph nodes and lymphatic tissues. In some cases, NHL involves bone marrow and blood.
• Isn't just one disease–it's actually a diverse group of blood cancers that share a single characteristic in how they develop
• NHL has many different subtypes which are either indolent (slow growing) or aggressive (fast growing).

Click here to access NHL statistics.

What You Should Know

• Hematologists and oncologists are specialists who treat people who have NHL or other types of blood cancer.
• Treatment for people who have NHL may include drug therapy and radiation therapy.
• It's important to know your NHL subtype

 
What You Should Do

• Seek treatment in a cancer center where doctors are experienced treating patients with lymphoma.
• Talk with your doctor about your diagnostic tests and what the results mean.
• Be sure you know your NHL subtype - different subtypes have different treatments.

 
How Does NHL Develop?

NHL usually starts with an abnormal change in a white cell in a lymph node or lymphoid tissue called a lymphocyte. It can start in one of three major types of lymphocytes:

• B lymphocytes (B cells), which produce antibodies to help combat infections
• T lymphocytes (T cells), which have several functions, including helping B lymphocytes make antibodies
• Natural killer (NK) cells, which attack virus-infected cells or tumor cells

About 85 percent of NHL cases start in the B cells. Your doctor plans your treatment according to the type of cell your NHL developed in.

The abnormal lymphocyte grows out of control and produces more abnormal cells like it.

• These abnormal lymphocytes (lymphoma cells) accumulate and form masses (tumors). If NHL isn't treated, the cancerous cells crowd out normal white cells, and the immune system can't guard against infection effectively.
• NHL that develops in or spreads to other areas of the body where lymphoid tissue is found, such as the spleen, digestive tract and bone marrow, is called primary extranodal lymphoma.
• NHL is classified into more than 30 different subtypes. Doctors classify the NHL subtypes into categories that describe how rapidly or slowly the disease is progressing:
  • Aggressive NHL
  • Indolent (slow-growing) NHL

 
Risk Factors

Doctors don't know why some cells become non-Hodgkin lymphoma (NHL) cells and others don't. For most people who have NHL, there are no obvious reasons why they developed the disease.

Researchers have identified certain potential risk factors that can increase the chance of developing NHL. They've found that people who live and work in farming communities tend to have a higher incidence of NHL. Studies suggest there might be a link to some ingredients in herbicides and pesticides.

Researchers also think NHL may be associated with exposure to certain bacteria and viruses, especially those that suppress the immune system, such as:

• Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS)
• Epstein-Barr virus
• Human T-lymphocytotropic virus (HTLV)
• Helicobacter pylori (the bacteria that causes stomach ulcers)

You can't catch NHL from someone else. Experts have found that about a dozen inherited - but rare - syndromes may increase NHL risk.

Source: Non-Hodgkin Lymphoma. Reviewed by Carla Casulo, MD and Lynn Rich, MS, NP.