Non-Hodgkin lymphoma

Non-Hodgkin lymphoma (NHL) is a heterogeneous group of malignancies arising from lymphocytes, the white blood cells that form a critical part of the immune system. NHL encompasses a wide range of subtypes, broadly classified into B-cell lymphomas (which account for approximately 85-90% of cases) and T-cell or NK-cell lymphomas. Unlike Hodgkin lymphoma, NHL typically lacks the characteristic Reed-Sternberg cells. The disease primarily affects the lymphatic system, including lymph nodes, spleen, and bone marrow, but can involve virtually any organ in the body, including the gastrointestinal tract, skin, central nervous system, and lungs. Key symptoms include painless swelling of lymph nodes (lymphadenopathy), often in the neck, axillae, or groin, along with constitutional 'B symptoms' such as unexplained fever, drenching night sweats, and unintentional weight loss exceeding 10% of body weight over six months. Patients may also experience fatigue, recurrent infections, easy bruising or bleeding, and abdominal pain or fullness due to splenomegaly or hepatomegaly. Some subtypes present with extranodal involvement, leading to organ-specific symptoms. The causes of NHL are multifactorial, involving a combination of genetic susceptibility, immune dysregulation, and environmental factors. Risk factors include immunodeficiency (congenital or acquired, including HIV infection), autoimmune conditions, prior organ transplantation with immunosuppressive therapy, and certain infections such as Epstein-Barr virus, Helicobacter pylori, and hepatitis C virus. Treatment depends on the specific subtype, stage, and patient factors, and may include chemotherapy, immunotherapy (such as rituximab for B-cell lymphomas), radiation therapy, targeted therapies (including BTK inhibitors and PI3K inhibitors), CAR-T cell therapy for relapsed or refractory cases, and stem cell transplantation. Indolent subtypes may initially be managed with watchful waiting, while aggressive subtypes typically require prompt combination chemotherapy. Prognosis varies widely depending on the subtype, with some indolent forms having a prolonged course and aggressive forms being potentially curable with intensive treatment.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Non-Hodgkin lymphoma