Non-Hodgkin lymphoma (NHL)

Survival is higher when NHL is found at an earlier stage, and it differs a lot by type. The outlook section on this page gives five-year figures from U.S. cancer registry data (SEER), overall and by stage. These numbers mix many types. They cannot predict one person's outcome.

Often, but it depends on the type. NCI's summary for health professionals says many people with fast-growing (aggressive) NHL can be cured with intensive combination treatment. Slow-growing (indolent) NHL usually cannot be cured once it is advanced. Even so, it has a relatively good outlook, and many people live with it for a long time.

Both are lymphomas, cancers that form in the lymph system. NCI splits lymphoma into these two general types. Doctors tell them apart by studying a biopsy under a microscope and testing the cells. In Hodgkin lymphoma, large abnormal cells called Reed-Sternberg cells may be seen. NHL includes many more types. About 85% of NHL begins in B cells; most of the rest begins in T cells, and a few in NK cells.

Signs NCI lists include swollen lymph nodes in the neck, underarm, groin or belly. Others are fever with no known cause, drenching night sweats, feeling very tired and weight loss with no known cause. When fever, night sweats and weight loss occur together, they are called B symptoms. They affect the outlook and treatment options. These signs have many other causes, and a biopsy is needed to diagnose NHL.

NCI lists several things that raise the risk. They include being older, male or White, and having a weakened immune system. That can come from an inherited immune disorder, an autoimmune disease, HIV, or medicines taken after an organ transplant. Some infections also raise the risk, including Epstein-Barr virus, HTLV-1 and Helicobacter pylori. Having a risk factor does not mean a person will get NHL.

For most types, not as a first treatment. In European EBMT recommendations, a transplant is mostly used when lymphoma comes back or does not respond. Some types, such as primary CNS lymphoma and some T-cell lymphomas, may include a transplant of the person's own stem cells after first treatment. For large B-cell lymphoma that does not respond to first treatment, or comes back within a year, EBMT names CAR T-cell therapy as the standard of care. If it comes back early but still responds to chemotherapy, high-dose treatment with the person's own stem cells is also an option. A donor transplant is considered for selected cases, such as mantle cell lymphoma when CAR T-cell therapy has failed or is not available.