What is non-hodgkin lymphoma?

Non-Hodgkin lymphoma (NHL) is a type of cancer that begins in the lymph system. White blood cells called lymphocytes grow abnormally and out of control. The cells can form lumps of tissue called tumors.

NHL may occur in a single lymph node, a group of lymph nodes, or an organ. It can spread to almost any part of the body. This can include the liver, bone marrow, and spleen.

NHL is not contagious and is not caused by an injury.

Treatment for NHL depends on the type and stage of the lymphoma. It is usually treated with medicines called chemotherapy. Your doctor may also give you medicines that work on the body's immune system (immunotherapy). You may also need radiation treatments or a procedure called a stem cell transplant. Your doctor will talk to you about what kind of treatment may be best for you.

With NHL, white blood cells in the lymph system grow out of control.

Lymph tissue is present in many areas of the body, so NHL can start almost anywhere. And it can spread to almost any part of the body, including the liver, bone marrow, and spleen.

NHL may be classified as:

• Slow-growing lymphomas, also called indolent lymphomas. They spread slowly and cause few symptoms.
• Fast-growing lymphomas, also called aggressive lymphomas. They spread quickly and can cause severe symptoms.

Over time, lymphoma cells may replace the normal cells in the bone marrow. When bone marrow fails, your body can't produce red blood cells that carry oxygen, white blood cells that fight infection, and platelets that stop bleeding.

How NHL affects you and how long you will live depends on many things. These include the type of NHL you have, the stage of the disease when you were diagnosed, and your response to treatments.

Symptoms of NHL include:

• A painless swelling of the lymph nodes in the neck, underarm, or groin. This is the most common symptom.
• Fever not caused by another health problem.
• Night sweats.
• Feeling very tired.
• Weight loss you can't explain.
• Itchy skin.
• Reddened patches on the skin.
• A cough or shortness of breath.
• Pain in the belly or back.

Treatment for NHL is based on the type of lymphoma, the stage of the cancer, and other things, such as your overall health. Treatment options may include:

Chemotherapy.

These medicines kill fast-growing cells, including cancer cells and some normal cells.

Immunotherapy.

This treatment helps your immune system fight cancer.

Radiation therapy.

This uses high-dose X-rays to destroy cancer cells and shrink tumors.

Targeted therapy.

These medicines target cancer cells and may cause less harm to normal cells.

Stem cell transplant.

This replaces damaged cells with healthy stem cells. They help your bone marrow make healthy blood cells.

For slow-growing NHL, a wait-and-see approach may be best. Your doctor will watch your condition closely. But you won't have treatment unless you're bothered by symptoms.

In some cases, a clinical trial may be a good choice.

Your doctor will talk with you about your options and then make a treatment plan.

Watchful waiting is often as effective as having treatment for some types of NHL. Some people with slow-growing NHL may live a long time without symptoms.

To diagnose NHL, your doctor will do a physical exam and ask you questions about your health. The exam includes checking the size of your lymph nodes in your neck, underarm, and groin.

Your doctor will take a piece of body tissue (biopsy) to diagnose NHL. The tissue usually is taken from a lymph node. You may have other tests to find out what kind of NHL you have.

Your doctor also will likely order:

• Blood tests.
• Imaging tests, such as a CT scan, MRI, or PET scan.
• Lab tests, such as flow cytometry. These are used to check the types of cells in a biopsy sample. These tests help your doctor find out the type of lymphoma.
• Lumbar puncture (also called a spinal tap). This is used find out whether lymphoma cells are in the fluid that surrounds your brain and spinal cord.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor, counselor, or other health professional.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.

Some things can put you at risk for getting NHL. These things are called risk factors. But many people who get NHL don't have any of these risk factors. And some people who have risk factors don't get the disease.

Risk factors include:

• Being male. NHL is more common in men than in women.
• Being older. The likelihood of getting NHL increases as you get older.
• Having an impaired immune system. NHL is most common among those who have an impaired immune system, an autoimmune disease, or HIV or AIDS. It also occurs among those who take immunosuppressant medicines, such as medicines following an organ transplant.
• Having certain viral infections. For example, Epstein-Barr virus increases the risk of getting NHL.
• Having certain bacterial infections. For example, infection with Helicobacter pylori puts you at risk of lymphoma that involves the stomach.
• Being exposed to some pesticides or fertilizers, solvents, and other chemicals.

The cause of NHL is not known. The abnormal cell changes may be triggered by an infection or exposure to something in the environment. There is also a link between NHL and problems with the immune system. Or it may be linked to gene changes (mutations). NHL is not contagious.

Non-Hodgkin lymphoma (NHL) is a type of cancer that begins in the lymph system in white blood cells called lymphocytes. When these cells become abnormal, they don't protect the body from infection or disease. They also grow without control and may form lumps of tissue called tumors.

NHL can start almost anywhere in the body. It may start in a single lymph node, a group of lymph nodes, or an organ such as the spleen. It can be slow-growing or fast-growing. And it can spread to almost any part of the body.

Treatments can work well for some people. For others, treatment may allow them to live longer than without treatment.