Understanding Non-Hodgkin Lymphoma -- Diagnosis & Treatment
Learn more about the diagnosis and treatment of non-Hodgkin lymphoma from the experts at WebMD.
Understanding Non-Hodgkin Lymphoma -- Symptoms
Information on the symptoms of non-Hodgkin lymphoma.
Radiation Therapy for Lymphoma and Leukemia
Radiation therapy is the use of high - dose X - rays to treat cancer cells that may remain after surgery, especially if all of the cancer cannot be removed. Radiation therapy is often used for the treatment of cancer, such as non - Hodgkin's lymphoma (NHL), Hodgkin's lymphoma, and all types of leukemias. Radiation therapy may be used alone or in combination with other treatment options, such as ..
Watchful Waiting (Surveillance) for Non-Hodgkin's Lymphoma
Watchful waiting (surveillance) is a period in the treatment of non - Hodgkin's lymphoma (NHL) in which little or no treatment is done. It does not mean that your health professionals are giving up or refusing to give you treatment. ...
Indolent non-Hodgkin lymphoma (NHL) includes the following subtypes:Follicular lymphoma.Lymphoplasmacytic lymphoma (Waldenström macroglobulinemia).Marginal zone lymphoma.Splenic marginal zone lymphoma.Primary cutaneous anaplastic large cell lymphoma.Follicular LymphomaFollicular lymphoma comprises 20% of all NHLs and as many as 70% of the indolent lymphomas reported in American and European clinical trials.[1,2,3] Most patients with follicular lymphoma are age 50 years and older and present with widespread disease at diagnosis. Nodal involvement is most common and is often accompanied by splenic and bone marrow disease. Rearrangement of the bcl-2 gene is present in more than 90% of patients with follicular lymphoma; overexpression of the bcl-2 protein is associated with the inability to eradicate the lymphoma by inhibiting apoptosis.PrognosisDespite the advanced stage, the median survival ranges from 8 to 15 years, leading to the
Treatment for Indolent, Noncontiguous Stage II / III / IV Adult NHL
Optimal treatment of advanced stages of low-grade non-Hodgkin lymphoma is controversial because of low cure rates with the current therapeutic options. Numerous clinical trials are in progress to settle treatment issues, and patients should be urged to participate. The rate of relapse is fairly constant over time, even in patients who have achieved complete response to treatment. Indeed, relapse may occur many years after treatment. Currently, no randomized trials guide clinicians about the initial choice of watchful waiting, rituximab, nucleoside analogs, alkylating agents, combination chemotherapy, radiolabeled monoclonal antibodies, or combinations of these options.; [Level of evidence: 1iiDiii]For patients with indolent, noncontiguous stage II and stage III non-Hodgkin lymphoma, central lymphatic radiation therapy has been proposed but is not usually recommended as a form of treatment.[3,4]Numerous prospective clinical trials of interferon-alpha,
Treatment for Aggressive, Noncontiguous Stage II / III / IV Adult NHL
The treatment of choice for patients with advanced stages of aggressive non-Hodgkin lymphoma (NHL) is combination chemotherapy, either alone or supplemented by local-field radiation therapy.The following drug combinations are referred to in this section:ACVBP: doxorubicin + cyclophosphamide + vindesine + bleomycin + prednisone.CHOP: cyclophosphamide + doxorubicin + vincristine + prednisone.CNOP: cyclophosphamide + mitoxantrone + vincristine + prednisone.m-BACOD: methotrexate + bleomycin + doxorubicin + cyclophosphamide + vincristine + dexamethasone + leucovorin.MACOP-B: methotrexate + doxorubicin + cyclophosphamide + vincristine + prednisone fixed dose + bleomycin + leucovorin.ProMACE CytaBOM: prednisone + doxorubicin + cyclophosphamide + etoposide + cytarabine + bleomycin + vincristine + methotrexate + leucovorin.R-CHOP: rituximab, an anti-CD20 monoclonal antibody, + cyclophosphamide + doxorubicin + vincristine + prednisone.Standard Treatment Options for
Stage Information for Adult NHL
Stage is important in selecting a treatment for patients with non-Hodgkin lymphoma (NHL). Chest and abdominal computed tomographic (CT) scans are usually part of the staging evaluation for all lymphoma patients. The staging system is similar to the staging system used for Hodgkin lymphoma.Common among patients with NHL is involvement of the following:Noncontiguous lymph nodes.Waldeyer ring.Epitrochlear nodes.Gastrointestinal tract.Extranodal presentations. (A single extranodal site is occasionally the only site of involvement in patients with diffuse lymphoma.)Bone marrow.Liver (especially common in patients with low-grade lymphomas).Cytologic examination of cerebrospinal fluid may be positive in patients with aggressive NHL. Involvement of hilar and mediastinal lymph nodes is less common than in Hodgkin lymphoma. Mediastinal adenopathy, however, is a prominent feature of lymphoblastic lymphoma and primary mediastinal B-cell lymphoma, entities primarily found in young
High-Stage Childhood Lymphoblastic Lymphoma Treatment
Patients with high-stage (stage III or IV) lymphoblastic lymphoma have long-term survival rates higher than 80%. Unlike other pediatric non-Hodgkin lymphoma (NHL), it has been shown that lymphoblastic lymphoma responds much better to leukemia therapy with 2 years of therapy than with shorter, intensive, pulsed chemotherapy regimens.[1,2,3]Involvement of the bone marrow may lead to confusion as to whether the patient has lymphoma or leukemia. Traditionally, patients with more than 25% marrow blasts are classified as having leukemia, and those with fewer than 25% marrow blasts are classified as having lymphoma. It is not yet clear whether these arbitrary definitions are biologically distinct or relevant for treatment design. All current therapies for advanced-stage lymphoblastic lymphoma have been derived from regimens designed for the treatment of acute lymphoblastic leukemia (ALL). Mediastinal radiation is not necessary for patients with mediastinal masses, except in the emergency
Changes to This Summary (02 / 19 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above. General Information About Adult Non-Hodgkin Lymphoma (NHL)Updated statistics with estimated new cases and deaths for 2013 (cited American Cancer Society as reference 2).Indolent NHLAdded text to state that follicular lymphoma in situ and primary follicular lymphoma of the duodenum are particularly indolent variants that rarely progress and rarely require therapy (cited Schmatz et al. and Jegalian et al. as references 17 and 18, respectively).Revised text to state that myeloablative therapy with autologous or allogeneic hematopoietic stem cell support is under clinical evaluation (cited Kyriakou et al. as reference 48).Added Nakamura et al. as reference 62.Added Kempf et al. as reference 97.Aggressive NHLAdded Glantz et al. as reference 18.Added text to state that similar response rates in