Non-Hodgkin Lymphoma: Types, Symptoms, and Treatments

Written by Medicover Team and Medically Reviewed by Dr Neelesh Kanderi , Oncologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Non-Hodgkin lymphoma (NHL) is a broad category of blood cancers that includes many different types of lymphoma.

The lymphatic system includes lymph nodes, spleen, thymus gland, and bone marrow. NHL occurs when lymphocytes, a type of white blood cell, grow uncontrollably, forming tumors in the lymph nodes and other parts of the lymphatic system.

What Are the Types of Non-Hodgkin Lymphoma?

There are numerous types of non-Hodgkin lymphoma, classified primarily based on the type of lymphocyte affected: B cells or T cells. Understanding the specific type is crucial for determining the appropriate treatment plan. Below are some common types:

B-cell Lymphomas

Diffuse Large B-cell Lymphoma (DLBCL): The most prevalent form of NHL, DLBCL is aggressive but potentially curable with timely treatment.
Follicular Lymphoma: A slower-growing form of NHL that is often diagnosed at an advanced stage but can be managed over time.
Mantle Cell Lymphoma: A rare, aggressive form of B-cell NHL that often requires intensive treatment.

T-cell Lymphomas

Peripheral T-cell Lymphoma: A group of aggressive lymphomas with treatment varying according to the specific subtype.
Cutaneous T-cell Lymphoma: Primarily affects the skin but can progress to involve lymph nodes and internal organs.

What Are the Symptoms of Non-Hodgkin Lymphoma?

Recognizing the symptoms of NHL is important for early evaluation and treatment. Common symptoms include:

Swollen Lymph Nodes: Painless swelling in the neck, armpit, or groin.
Fever and Night Sweats: Persistent fever and excessive sweating during the night.
Weight Loss: Unexplained weight loss over a short period.
Fatigue: A general feeling of tiredness or weakness.
Abdominal Pain or Swelling: May result from an enlarged spleen or enlarged lymph nodes.

What Are the Causes of Non-Hodgkin Lymphoma?

The exact cause of non-Hodgkin lymphoma remains unknown, but several factors may increase the risk of developing NHL. These include:

Age and Gender: NHL is more common in older adults, and certain types are more prevalent in men.
Immune System Deficiency: Individuals with weakened immune systems, whether from inherited conditions, HIV/AIDS, or immunosuppressive medications, have an increased risk.
Infections: Certain viral and bacterial infections, such as Epstein-Barr virus and Helicobacter pylori, are associated with an increased risk of certain NHL subtypes.
Environmental Exposure: Prolonged exposure to certain chemicals, such as pesticides and herbicides, may be associated with an increased risk of NHL.

What Are the Risk Factors for Non-Hodgkin Lymphoma?

Several factors may increase the likelihood of developing non-Hodgkin lymphoma. Having a risk factor does not mean that a person will develop NHL, and some people develop the disease without any identifiable risk factors.

Older age: The risk of NHL generally increases with age, although some subtypes are more common in younger people.
Weakened immune system: Conditions or medicines that suppress immune function can increase the risk of NHL.
Autoimmune diseases: Certain autoimmune conditions are associated with an increased risk of some lymphoma subtypes.
Certain infections: Infections such as Epstein-Barr virus, hepatitis C virus, and Helicobacter pylori are associated with certain types of NHL.
Previous cancer treatment: Some chemotherapy or radiation treatments may rarely increase the risk of developing lymphoma later.

When Should You See a Doctor for Non-Hodgkin Lymphoma?

Consult an oncologist if you experience persistent swollen lymph nodes or unexplained symptoms that may require further evaluation. Early diagnosis allows timely treatment and helps determine the most appropriate management approach.

Painless swollen lymph nodes in the neck, armpit, or groin lasting more than two weeks.
Persistent fever without an obvious infection.
Unexplained weight loss.
Drenching night sweats.
Persistent fatigue or weakness.
Abdominal pain, fullness, or swelling.
Chest pain, persistent cough, or shortness of breath.
Frequent infections or unexplained bleeding or bruising.

Prompt evaluation by a specialist can help determine the cause of these symptoms and, when necessary, confirm a diagnosis and begin appropriate treatment.

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How Is Non-Hodgkin Lymphoma Diagnosed?

The diagnosis of NHL typically involves a combination of a physical examination, blood tests, imaging studies, and biopsy. A lymph node biopsy is often necessary to confirm the diagnosis and determine the specific type of lymphoma. Advanced imaging techniques such as PET scans and CT scans help evaluate the extent of disease and identify areas involved by lymphoma.

Physical examination: The doctor checks for enlarged lymph nodes, an enlarged spleen, and other signs that may suggest lymphoma.
Blood tests: Blood tests help assess overall health and identify abnormalities that may support the evaluation.
Lymph node biopsy: A tissue sample is examined under a microscope and with specialized laboratory tests to identify the lymphoma subtype.
CT or PET-CT scans: These imaging studies help determine where lymphoma is present and assess the extent of disease.
Bone marrow examination: May be recommended in selected cases to determine whether lymphoma has involved the bone marrow.

What Are the Treatment Options for Non-Hodgkin Lymphoma?

The treatment approach for NHL depends on the type, stage, and aggressiveness of the lymphoma, as well as the patient's overall health. Treatment may involve one or more of the following approaches:

Chemotherapy

Chemotherapy uses medicines to kill cancer cells or stop them from dividing. Combination chemotherapy regimens, such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), are frequently used for certain types of NHL.

Radiation Therapy

Radiation therapy uses high-energy beams to target and destroy cancer cells. It may be used for some early-stage lymphomas, localized disease, or in combination with other treatments.

Immunotherapy

Immunotherapy uses the body's immune system to help fight cancer. Rituximab, a monoclonal antibody, targets the CD20 protein on many B cells and is commonly used for several B-cell lymphomas.

Stem Cell Transplantation

In selected cases, high-dose chemotherapy followed by an autologous or allogeneic stem cell transplant may be recommended, particularly for certain relapsed or refractory lymphomas.

Targeted Therapy

Targeted therapies act on specific molecules or pathways involved in lymphoma cell growth and survival. These medicines provide treatment options for certain NHL subtypes and may be used alone or in combination with other therapies.

The treatment plan is individualized according to the lymphoma subtype, stage, molecular features, response to previous treatment, and overall health.

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What Is the Prognosis for Non-Hodgkin Lymphoma?

The prognosis for non-Hodgkin lymphoma varies significantly depending on the specific type and stage of the disease, the patient's age and overall health, and how well the lymphoma responds to treatment. Many types of NHL can be effectively treated, and some aggressive lymphomas can be cured with appropriate therapy. Early diagnosis and a tailored treatment plan can improve disease control and long-term outcomes.