T-cell lymphoma

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on May 31, 2022.

T-cell lymphoma is a type of non-Hodgkin lymphoma (NHL), which is a cancer that originates in the lymph tissue.

Lymph tissue is found in the:

  • Lymph nodes
  • Spleen
  • Bone marrow
  • Thymus
  • Adenoids and tonsils
  • Digestive tract

Lymph tissue contains lymph, a colorless, watery fluid that travels through the lymph vessels and carries lymphocytes (white blood cells). These white blood cells are part of your body’s immune response to infection. Lymphomas originate in those white blood cells.

The three categories of infection-fighting lymphocytes are: B-cell, T-cell and natural killer (NK) cells.

T-cell lymphomas are fairly rare and make up less than 15 percent of non-Hodgkin lymphomas in the United States, according to the American Cancer Society (ACS). There are many types of T cells. Some are responsible for destroying germs or abnormal cells in your body, while others help regulate immune system cells.

Symptoms of T-cell lymphoma

Symptoms of T-cell lymphoma vary widely based on the type of lymphoma, but below are some of the more common ones, including:

  • Swollen lymph nodes
  • Fever
  • Night sweats
  • Weight loss
  • Fatigue
  • Rash or itchy skin
  • Pain in the chest, abdomen or bones

Lymphoma occurs when certain gene changes, called mutations, form within white blood cells. However, it’s unclear why this happens or whether it’s hereditary.

Several factors are known to raise the risk of non-Hodgkin lymphoma, and possibly T-cell lymphoma, including:

  • Older age
  • Certain viral infections
  • Problems with the immune system

Since there are many types of T-cell lymphoma, certain risk factors may be more relevant for one type than another. For example, being infected with a virus called human T-cell lymphotropic virus (HTLV-1) is a known risk factor for some types of T-cell lymphoma, especially adult T-cell leukemia/lymphoma.

Types of T-cell lymphoma

There are many types of T-cell lymphoma, including:

  • T-lymphoblastic lymphoma/leukemia
  • Peripheral T-cell lymphomas, which is one of the following:
  • Cutaneous T-cell lymphomas
  • Adult T-cell leukemia/lymphoma
  • Angioimmunoblastic T-cell lymphoma
  • Extranodal natural killer/T-cell lymphoma, nasal type
  • Enteropathy-associated intestinal T-cell lymphoma (EATL)
  • Anaplastic large cell lymphoma (ALCL)
  • Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS)

T-lymphoblastic lymphoma/leukemia

In this disease, the cancer cells are very early forms of T cells. T-lymphoblastic lymphoma/leukemia accounts for 1 percent of lymphomas, according to the ACS, and is commonly seen in teenagers and young adults. Males are more likely to be affected than females. Leukemia is a cancer of the bone marrow (where new blood cells are made), so depending on how much of the bone marrow is involved, the disease may be considered lymphoma or a type of acute lymphoblastic leukemia (ALL).

This cancer typically originates in the thymus, which is a small organ behind the breastbone and in front of the heart that makes T cells. It may grow into a large tumor in the area between the lungs. The most common symptom for this kind of T-cell lymphoma is labored breathing and swelling in the arms and face.

While this disease grows quickly, if it hasn’t spread to the bone marrow by the time of diagnosis, then chemotherapy is typically the recommended treatment.

Peripheral T-cell lymphomas

Cutaneous T-cell lymphoma (CTCL) begins in the skin and can cause a wide variety of rashes and other changes depending on the subtype and stage of the cancer. Skin lymphomas make up about 5 percent of all lymphomas, according to the ACS. The potential signs of CTCL include:

  • Patches of scaly, red skin that may be itchy
  • Raised patches called plaques that may be itchy 
  • Skin growths (tumors) that may resemble mushrooms 
  • Reddened skin across large areas of the body that is often very itchy and may be thick, scaly or peeling

Adult T-cell leukemia/lymphoma may result from an infection with a virus called HTLV-1. It may affect the bone marrow, lymph nodes, spleen, liver, skin and other organs. This lymphoma is further broken down into one of four subcategories.

  • Smoldering, which grows slowly and has few to no symptoms and typically responds well to treatment
  • Chronic, which grows slowly and typically responds well to treatment
  • Acute, which is the most common type, grows quickly and must be treated immediately
  • Lymphoma, which grows more quickly than chronic and smoldering, but not as quickly as the acute type

Angioimmunoblastic T-cell lymphoma, which progresses quickly, often involves the lymph nodes, bone marrow and spleen or liver. More common in older adults, angioimmunoblastic T-cell lymphoma accounts for about 4 percent of all lymphomas, according to the ACS. Treatment is usually effective at first, but the lymphoma has a high recurrence rate.

Extranodal natural killer/T-cell lymphoma, nasal type, is rare and involves the nose and upper throat. It may also spread to the skin, digestive tract and other organs.

Enteropathy-associated intestinal T-cell lymphoma (EATL) occurs most commonly in the small intestine, but it may also occur in the colon. This lymphoma occurs in some patients with celiac disease, an autoimmune disorder in which eating gluten causes the immune system to attack the lining of the intestine and other parts of the body. This lymphoma is more commonly diagnosed in male patients.

Anaplastic large cell lymphoma (ALCL) is most common in children and young adults and makes up about 2 percent of lymphomas, according to the ACS. Although ALCL is often fast-growing, the prognosis is still good. The different forms of ALCL include:

  • Primary cutaneous ALCL, which affects the skin
  • Systemic ALCL, which may affect the lymph nodes and other organs, including the skin
  • Breast implant-associated ALCL, which is considered a rare type and may develop in the breasts of women with implants

Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS), often involves the lymph nodes but may also affect the skin, bone marrow, spleen, liver and digestive tract. Patients may receive this diagnosis if they have a T-cell lymphoma that isn’t one of the above lymphomas. These patients may be in their 60s. Generally speaking, these lymphomas are often widespread and fast-growing. Though some patients respond well to chemotherapy, this type of lymphoma may become difficult to treat over time.

Treatment for T-cell lymphoma

Much of the research being done on T-cell lymphoma is focused on looking at new and better ways to treat this disease. Treatment depends on the type of T-cell lymphoma and its progression. Current treatment options include:

T-cell lymphoma survival rates

Cancer survival statistics are often given as five-year relative survival rates, which estimate how likely it is that people with a specific cancer will live for at least five years after their diagnosis compared with those without that cancer. These numbers are only estimates, and they don’t account for all of the many variables that influence individual outcomes.

T-cell lymphoma is rare, and there is limited survival data for this cancer. Also, each type of T-cell lymphoma is unique and comes with different outcomes. The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program has some survival statistics for different T-cell lymphoma subtypes. However, the data is based on patients diagnosed between 2004 and 2010, and survival rates have likely changed as treatment options have advanced.

According to SEER, the overall survival rate for all types of T-cell non-Hodgkin lymphoma was 63.1 percent. In other words, the data suggests that, on average, people with T-cell non-Hodgkin lymphoma are about 63 percent as likely as people without the cancer to live five or more years after their diagnosis.

Here are the five-year relative survival rates for different types of T-cell lymphoma based on data from 2004 to 2010:

  • Peripheral T-cell lymphomas: 56 percent
  • Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS): 37 percent
  • Cutaneous T-cell lymphomas (Mycosis fungoides/Sezary syndrome): 89.4 percent
  • Adult T-cell leukemia/lymphoma: 57 percent
  • Angioimmunoblastic T-cell lymphoma: 43.4 percent
  • Extranodal natural killer/T-cell lymphoma, nasal type: 41.6 percent

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