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Non-Hodgkin lymphoma

Top questions about non-Hodgkin lymphoma

What you should know about non-Hodgkin lymphoma

What are the signs and symptoms of non-Hodgkin lymphoma?

Common symptoms of non-Hodgkin lymphoma include:

  • Fever
  • Chills and/or night sweats
  • Fatigue
  • Loss of appetite
  • Dramatic and unexplained weight loss
  • Abdominal discomfort, pain or bloating
  • Headaches
  • Bone or joint pain
  • Shortness of breath
  • Rash or itching
  • Swollen lymph nodes

These symptoms may also affect some patients with Hodgkin lymphoma or leukemia. Some symptoms of leukemia and lymphoma, such as fever, chills and swollen lymph nodes, may resemble the flu. But in lymphoma or leukemia patients, these symptoms do not go away. If these symptoms persist for more than two weeks, see your doctor.

Can non-Hodgkin lymphoma be prevented?

The cause of non-Hodgkin lymphoma is unknown, but risk factors include:

Age: The median age of a patient diagnosed with non-Hodgkin lymphoma is 67, according to the National Cancer Institute. Most cases—67 percent—are diagnosed in patients between the ages of 55 and 84.

Previous illness: Patients who have had organ transplants, immune disorders or diseases that affect the immune system, such as HIV/AIDS, may be at a higher risk of lymphoma.

Exposure: Those exposed to radiation or who had radiation therapy at a young age may be at higher risk. Researchers are exploring whether exposure to certain chemicals and pesticides is a possible risk factor, according to the American Cancer Society.

Gender and race: Non-Hodgkin lymphoma is diagnosed more often in men and more often in Caucasians.

Questions about non-Hodgkin lymphoma treatment

What kinds of tests will I need to determine if I have lymphoma, and, if I do, to diagnose the type of lymphoma I have?

Patients may undergo a variety of tests to determine whether they have lymphoma or leukemia and to diagnose the stage or progression of the disease. In most cases, a biopsy is performed, retrieving a tissue sample from a lymph node or bone marrow. The sample is then examined under a microscope by a pathologist. A blood test may also be performed to rule out infection or other diseases.

Other tests used to diagnose the type or stage of the disease include a lumbar puncture (spinal tap), flow cytometry to look for abnormal DNA, and imaging tests, such as a CT scan or MRI.

What types of treatments are used for non-Hodgkin lymphoma?

The primary treatments for non-Hodgkin lymphoma are chemotherapy, immunotherapy, stem cell transplantation, radiation therapy and targeted therapy.

Chemotherapy may be used to fight all forms of non-Hodgkin lymphoma. Doctors may use a combination of up to four chemotherapy drugs to treat more aggressive types of the disease. Intensive treatment with higher doses of chemotherapy may be used prior to a stem cell transplant, in which healthy stem cells are given to the patient intravenously, similar to a blood transfusion. These healthy cells travel to the bone marrow, where they reproduce more healthy blood cells.

Monoclonal antibody therapy is a type of targeted therapy designed to seek out specific gene mutations or proteins on cancer cells and kill those cells, or help other therapies work better. Radiation therapy may be used to destroy lymphoma cells or relieve pain and discomfort caused by an enlarged spleen or swollen lymph nodes.

These therapies may be used alone or in combination with one another.

How will non-Hodgkin lymphoma affect my quality of life?

The impact non-Hodgkin lymphoma has on a patient depends largely on the type of the disease and the type of treatment prescribed. Because lymphoma affects B cells or T cells, it may make it difficult for a patient to fight off infection.

Some cases of indolent, or slow-growing, lymphoma require only active surveillance and no immediate treatment. Other cases require aggressive treatment, such as high-dose chemotherapy and stem cell transplantation. These types of treatments often cause side effects, such as nausea, weight loss and a compromised immune system.

Questions to ask your doctor

What are the different types of non-Hodgkin lymphoma?

Non-Hodgkin lymphoma has dozens of types and subtypes, each depending on whether the cancer started in B lymphocytes or T lymphocytes, which are white blood cells that help the body fight off disease. Most cases of non-Hodgkin lymphomas are B-cell lymphomas. Lymphomas are also characterized by how aggressive (fast-growing) or how indolent (slow-growing) they are. Diffuse large B-cell lymphoma, considered an aggressive lymphoma, is the most common form of non-Hodgkin lymphoma.

What’s the difference between Hodgkin lymphoma and non-Hodgkin lymphoma?

The primary difference between Hodgkin and non-Hodgkin lymphomas is whether Reed-Sternberg cells are found in a lymph node biopsy. Reed-Sternberg cells are found in patients diagnosed with Hodgkin lymphoma. These mutated B cells are very large compared to other cells. The various shapes of Reed-Sternberg cells often help pathologists determine the specific type of Hodgkin lymphoma. A common variety of these cells has at least two nuclei, giving them the appearance of owls’ eyes. Reed-Sternberg cells are named for the two scientists who first identified them under a microscope.

What’s the difference between leukemia and lymphoma?

Leukemia and lymphoma share many common symptoms and characteristics. Both diseases are considered blood cancers, or liquid cancers, and originate in lymphocytes, which are the white blood cells that help the body fight off disease. In patients with leukemia and lymphoma, white blood cells grow out of control and crowd out healthy cells. When the mutated cells are found in the blood, the disease is diagnosed as leukemia. When the cells are found in the lymph nodes, the cancer is considered lymphoma.

Leukemic cells are more likely to remain in the blood and circulate throughout the body. Lymphoma cells may also circulate, but they are more likely than leukemic cells to develop solid tumors in the lymph system, such as in lymph nodes or the spleen.

Despite the similarities, the diseases are often diagnosed and treated in different ways. The diseases are also distinguished in other ways. For instance, lymphoma is characterized by two types, Hodgkin lymphoma and non-Hodgkin lymphoma, and each disease has multiple varieties, as does leukemia.