What is Non-Hodgkin's Lymphoma?

Non-Hodgkin's lymphoma is cancer of the white blood cells, or lymphocytes. Non-Hodgkin lymphomas are divided into two main groups: B-cell lymphomas and T-cell lymphomas, and more than 60 sub-types based on location and features of the lymphocyte. Cancerous lymphocytes can travel to many parts of the body, where they can accumulate and develop into tumors. 

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of non-Hodgkin lymphoma. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

The most common symptom of non-Hodgkin's lymphoma is enlarged lymph nodes in the neck, under the arm, or in the groin. These are generally painless, and may grow larger over time. Other general symptoms of non-Hodgkin's lymphoma can include:

• Fever
• Night sweats
• Unexplained weight loss 
• Fatigue or lack of energy 
• Lack of appetite
• Severe or frequent infections
• Easy bruising or bleeding

Because lymphomas can affect many different parts of the body, other symptoms that may occur depending on the location of the lymphoma can include:

• In the abdomen: Swollen abdomen
• In the chest: Chest pain, shortness of breath or cough 
• In the brain or spinal cord: Headache, trouble thinking, speaking or seeing, facial numbness, weakness in the extremities, personality changes and seizures 
• In the skin: Itchy red or purple bumps under the skin 

Diagnosis

To determine if someone has non-Hodgkin's lymphoma, we ask about medical history and conduct a physical exam to check for swollen lymph nodes as well as a swollen spleen or liver. We also use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Lymph node biopsy: The physician may remove all or part of a lymph node and examine it for cancer.

Blood test: Blood tests check for certain proteins or cancer cells or if there are too few or too many blood cells that could indicate cancer.

Computed tomography (CT) scan: A series of detailed pictures, taken from different angles, are created by a computer linked to an x-ray machine. This scan can show abnormalities like enlargement of the lymph nodes, spleen and/or liver as well as signs if the cancer has spread.

Magnetic resonance imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the area where the lymphoma is suspected. 

Positron emission tomography (PET) scan: This imaging test uses a radioactive substance called a tracer to look for disease in the body.

Depending on where the suspected lymphoma is located, other tests such as chest x-rays, bone scans or echocardiograms may be performed. 

Causes

In most cases, there is no known cause for lymphoma. However, prolonged exposure to certain pesticides, fertilizers and organic solvents are known to increase the risk for non-Hodgkin's lymphoma. Research has also suggested that being overweight or obese may be a cause of non-Hodgkin's lymphoma. 

Risk Factors

Risk factors for non-Hodgkin's lymphoma include:

Age: Most people diagnosed with non-Hodgkin's lymphoma are age 60 or older.

Family history: There is no well-established hereditary pattern, but a family history of non-Hodgkin's lymphoma increases risk for the disease.

A compromised immune system: Autoimmune diseases and immunosuppressant medications used to prevent organ rejection in transplant recipients increase the risk for non-Hodgkin's lymphoma.

Viruses and bacteria: Viruses such as HIV/AIDS, Epstein-Barr, HTLV-1 and hepatitis C and bacteria such as H-pylori increase the risk for non-Hodgkin's lymphoma.

Radiation and chemotherapy: Treatments for other types of cancer increase the risk for non-Hodgkin's lymphoma.

Prevention

Most people with non-Hodgkin's lymphoma have no risk factors that can be changed. However, limiting exposure to chemicals that may cause non-Hodgkin's lymphoma and limiting risk factors for viruses such as HIV can help prevent the disease.

Prognosis

The prognosis for people with non-Hodgkin's lymphoma can vary widely based on the type of lymphoma and how advanced the lymphoma is when treatment begins. Younger patients and those whose lymphomas are confined to a small number of lymph nodes have a much better prognosis than patients over age 60 or patients who have lymphomas that have spread to numerous lymph nodes or organs outside the immune system. 

Treatment and Recovery

Non-Hodgkin's lymphoma treatment depends on the stage and location of the cancer. The main treatments for non-Hodgkin lymphoma are:

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream.

Immunotherapy 

This treatment uses a synthetic version of immune system cells that are designed to help the body boost its natural defenses to fight the cancer.

Radiation Therapy

This treatment uses high-energy radiation to kill cancer cells. Most often, radiation treatments are given five days a week for several weeks. 

Stem Cell Transplant 

A stem cell transplant replaces diseased cells with healthy cells that grow new bone marrow. A stem cell transplant may be considered if Hodgkin's disease returns despite treatment. During a stem cell transplant, a person’s blood stem cells are removed, frozen and stored before he or she undergoes high-dose chemotherapy and radiation therapy. The stem cells are then thawed and injected into the body.

Complications

Complications from non-Hodgkin's lymphoma are caused by the depletion of normal white blood cells and side-effects from treatment. These may include:

Frequent infections: Because lymphoma affects the white blood cells that fight infections, your immune system is compromised and you are more prone to infections. 

Recurring cancer: Because treatment can damage healthy cells, a person treated for lymphoma is at risk for developing other types of cancer.

Heart and lung disease: People with lymphoma have a higher risk of also developing heart and lung disease.