What Is Non-Hodgkin Lymphoma?

Non-Hodgkin lymphoma (NHL) is more common than Hodgkin lymphoma: Each year, about 72,680 people in the U.S. are diagnosed with some form of NHL.

There are more than 30 different subtypes of NHL, divided into two groups —B-cell lymphomas and T-cell lymphomas.

B-cell lymphomas:

Most non-Hodgkin lymphomas (85%) fall into this category. Subtypes include:

  • Diffuse large B-cell lymphoma (DLBCL) – The most common form of non-Hodgkin lymphoma in adults, DLBCL takes its name from the fact that the lymphoma cells are large. About 30-35% of people with NHL have DLBCL, which occurs mostly in older adults. There are several subtypes of DLBCL, including primary mediastinal B-cell lymphoma, which is diagnosed most often in young women. In most cases, DLBCL begins in the chest or abdomen, armpit or neck. Although it grows rapidly and is aggressive, it can be cured. FDA-approved CAR T-cell therapies (available at Roswell Park) represent a breakthrough in the treatment of this disease.
  • Follicular lymphoma – This accounts for about 20% of all NHL cases and is diagnosed mostly in people 60 or older.
  • Chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL).  
  • Mantle cell lymphoma – About 5% of lymphoma patients have this NHL subtype, which is most common in men 60 and over.
  • Marginal zone lymphomas make up about 5-10% of lymphomas.
  • Burkitt lymphoma – This occurs more often in children than adults and represents about 1-2% of all lymphomas.
  • Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia) – The lymphoma cells are small and occur mostly in the lymph nodes, spleen and bone marrow. This type represents only 1-2% of all lymphomas.
  • Hairy cell leukemia – This rare lymphoma involves small lymphocytes that look as if there are little hairs around the edges. It tends to grow so slowly that treatment is not always necessary.
  • Primary central nervous system (CNS) lymphoma – This is diagnosed most frequently in the elderly and people whose immune systems have been weakened due to AIDS or organ transplantation. It affects the central nervous system, which includes the brain and spinal cord.

T-Cell Lymphomas

About 15% of non-Hodgkin lymphomas are T-cell lymphomas. This group includes many subtypes, including some so rare that they account for just a few new diagnoses worldwide every year. That’s why it’s important to be sure your diagnosis is made by specialists who have extensive experience in identifying specific lymphomas.

Here are the most common types:

  • Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS): About 25% of all T-cell lymphomas fall into this category. PTCL-NOS is a label given to lymphomas that pathologists cannot definitely match up with a type that is already known. Different patients may have very different symptoms.
  • Anaplastic large-cell lymphoma (ALCL): About 12-15% of T-cell lymphomas fall into this group, which includes several subtypes. It affects mostly children and young adults, and more men than women. It can begin in the skin, lymph nodes or organs anywhere in your body.
  • Angioimmunoblastic lymphoma: Between 15 and 18% of all T-cell lymphomas in the U.S. are angioimmunoblastic lymphomas, which tend to grow quickly. They most often affect the elderly.
  • Cutaneous T-cell lymphoma: This group includes several subtypes. Cutaneous T-cell lymphomas grow slowly and make up about 2-3% of all cases of non-Hodgkin lymphoma. More men than women get CTCL, and mostly it affects people from age 40-60.

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