TRAINING and EDUCATION
Patient Education
UNDERSTANDING
NON-HODGKIN LYMPHOMA
There are two major types of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma
(NHL). NHL is the sixth most common cancer in men and the seventh most common in
women; about 71,000 people in the United States are expected to be diagnosed with NHL
in 2015. Read below for information about the causes, diagnosis, and treatment of NHL.
This “Patient Education” tear sheet was produced in collaboration with the Leukemia & Lymphoma Society (LLS).
What is NHL?
Non-Hodgkin lymphoma (NHL) is a type of cancer that
affects the lymphatic system. NHL is not just one disease,
but is the term used for a diverse group of blood cancers
that share a single characteristic: They arise from an injury
to the DNA of a lymphocyte parent cell. The altered DNA
in one lymphocyte produces a malignant transformation
– leading to the uncontrolled growth of the lymphocyte.
Accumulation of those cells results in the tumor masses
found in the lymph nodes and other sites in the body.
NHL generally develops in the lymph nodes or in
lymphatic tissue found in organs such as the stomach,
intestines, or skin. In some cases, NHL involves bone
marrow and blood.
How Does NHL Develop?
Doctors do not know why some cells become NHL cells
and others do not. For most people who have NHL, there
are no obvious reasons why they developed the disease.
NHL usually starts with an abnormal change in a lymphocyte – a white cell in a lymph node or lymphoid tissue.
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
Which Treatment Approach Is Right for You?
Cut out and give to a patient
The goal of NHL treatment is to destroy as many lymphoma cells as possible to induce a complete remission
(no trace of the disease). Patients who go into remission
are sometimes cured of the disease. Treatment can keep
NHL in check for many years, even if tests show some
lingering lymphoma cells (partial remission).
Your doctor plans your treatment based on several
factors, including:
• your disease subtype
• whether your disease is aggressive (fast-growing) or
indolent (slow-growing)
• your disease stage and category
• whether the lymphoma is in areas of your body other
than your lymph nodes
• your overall health and whether you have any conditions like heart disease, kidney disease, lung disease,
diabetes, or anemia
NHL has many different subtypes. Follicular lymphoma and
diffuse large B-cell lymphoma are the most common types
– together accounting for about 53 percent of cases.
ASHClinicalNews.org
As you develop a treatment plan with your doctor, be
sure to discuss:
• the results you can expect from treatment
• potential long- and late-term side effects
• the possibility of participating in a clinical trial, where
you’ll have access to advanced medical treatment that
may be more beneficial to you than standard treatment
Types of Treatment
Doctors use several types of approaches and treatment
combinations for NHL, depending on the subtype and
stage of disease. Approaches can include:
• chemotherapy and other drug therapy
• radiation therapy, usually combined with
chemotherapy
• stem cell transplantation
• watch-and-wait approach
Your doctor may suggest that you participate in a clinical trial. Clinical trials can involve therapy with new drugs
and new drug combinations or new approaches to stem
cell transplantation.
Follow-up Care
Once NHL is in remission, you will need to visit your doctor
for regular follow-up care. He or she monitors your health
and looks for signs that you may need more treatment.
Some treatments can cause long-term effects or late effects.
Not everyone suffers from long-term and late effects
of treatment, but for some patients the effects can range
from mild to severe. Your risk for developing long-term or
late effects can be influenced by:
• your treatment type and duration
• your age at the time of treatment
• your gender
• your overall health
Your doctor will let you know how often you need physical
exams and blood tests to check your blood cell counts. Your
hematologist/oncologist will screen you for cancer recurrence and the development of a secondary cancer. This may
include bone marrow tests to detect cancerous cells.
If you continue to show no signs of NHL and longterm or late effects, your doctor may suggest longer
periods between visits.
Researchers are working to improve their understanding of long-term and late effects and create guidelines
for follow-up care. If you would like to contribute to t \[\ܝ[