Diagnosis guide · Lymphomas
T-cell lymphoma
If you or someone you love has just heard this diagnosis, start here. It covers several subtypes, and this guide shows how they differ, so you can find the one on your report.
T-cell lymphomas are uncommon types of non-Hodgkin lymphoma that start in T cells or natural killer (NK) cells, two kinds of immune cell. They include peripheral T-cell lymphoma, angioimmunoblastic T-cell lymphoma and anaplastic large cell lymphoma, plus rarer types such as extranodal NK/T-cell, hepatosplenic and adult T-cell leukemia/lymphoma. Mycosis fungoides and Sézary syndrome affect the skin. The exact type matters. Some people with the more common types have a transplant of their own stem cells once first treatment has worked. European transplant guidance recommends a donor transplant during first treatment for some people with rarer, aggressive types, and one is considered when lymphoma comes back or does not respond. Skin types are treated differently.
In short
- T-cell lymphomas are uncommon types of non-Hodgkin lymphoma. They start in T cells or natural killer (NK) cells, two kinds of immune cell.
- The exact type matters, because types grow at different speeds and start in different places. Each type is also treated differently.
- Some people have a transplant of their own stem cells after first treatment. A donor transplant is considered for some rarer, aggressive types or when lymphoma comes back.
9 subtypes
Find the subtype on your report
The exact diagnosis shapes the treatment options. Your care team can explain the name on your report.
Peripheral T-cell lymphoma (PTCL-NOS)
Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), is a cancer of mature T cells that does not fit another defined subtype. Treatment often uses combination chemotherapy; selected patients may receive an autologous or donor transplant.
Usually the person’s own cellsAngioimmunoblastic T-cell lymphoma (AITL)
The World Health Organization’s 2022 classification calls angioimmunoblastic T-cell lymphoma “nodal T-follicular helper cell lymphoma, angioimmunoblastic-type.” It can disrupt immune function as well as cause lymphoma growth, and treatment may include selected stem cell transplant approaches.
Usually the person’s own cellsALK-positive anaplastic large cell lymphoma (ALCL)
ALK-positive anaplastic large cell lymphoma (ALCL) is a CD30-positive T-cell lymphoma driven by an ALK rearrangement. Many patients respond well to initial drug treatment; transplantation is mainly considered for selected higher-risk or relapsed disease.
Limited transplant roleALK-negative anaplastic large cell lymphoma (ALCL)
ALK-negative anaplastic large cell lymphoma (ALCL) is a CD30-positive T-cell lymphoma without an ALK rearrangement. Treatment commonly uses drug combinations, with autologous or donor transplantation considered in selected situations.
Usually the person’s own cellsExtranodal NK/T-cell lymphoma (ENKTL)
Extranodal NK/T-cell lymphoma is an Epstein-Barr virus-associated lymphoma that often affects the nose and nearby tissues. Treatment depends strongly on its extent; selected advanced or relapsed cases may benefit from a donor transplant.
Donor transplant optionHepatosplenic T-cell lymphoma (HSTCL)
Hepatosplenic T-cell lymphoma is a rare, aggressive lymphoma that mainly involves the liver, spleen and bone marrow. Early specialist treatment and donor-transplant assessment are important because ordinary lymphoma chemotherapy alone often gives short-lived control.
Donor transplant optionAdult T-cell leukemia/lymphoma (ATLL)
Adult T-cell leukemia/lymphoma (ATLL) is a cancer of mature T cells associated with long-standing HTLV-1 infection. Treatment differs by subtype; a donor transplant is an important potentially curative option for eligible people with aggressive disease.
Donor transplant optionMycosis fungoides
Mycosis fungoides is a T-cell lymphoma that usually begins in the skin. Early disease is often treated with skin-directed therapies; a donor stem cell transplant is an option for selected advanced or difficult-to-treat cases.
Limited transplant roleSézary syndrome
Sézary syndrome is a mature T-cell lymphoma involving the blood and usually causing widespread inflamed, itchy skin. Systemic treatment is central; a donor stem cell transplant can offer lasting remission for selected eligible patients.
Donor transplant option
Nearby
Related diagnosis guides
What to know
Key facts
- Share of non-Hodgkin lymphomas
- Less than 15%Share of all non-Hodgkin lymphomas, as summarized by NCI (PDQ updated 2025-05-13). Source: Share of non-Hodgkin lymphomas
- Linked to viruses
- HTLV-1 (adult T-cell leukemia/lymphoma); EBV (NK/T-cell lymphoma)As described by NCI (Adult NHL PDQ, patient version, updated 2024-08-22). Source: Linked to viruses
- Transplant consultation
- At diagnosis or first remission, and at relapseU.S. NMDP/ASTCT transplant consultation timing guidelines for T-cell and NK-cell lymphomas, accessed 2026-09-26. Source: Transplant consultation
- Donor transplant during first treatment
- Strongly recommended in Europe for hepatosplenic, NK/T-cell, adult T-cell and one rare intestinal typeEuropean EBMT transplant indications, 2025. Source: Donor transplant during first treatment
How T-cell lymphoma is diagnosed
A biopsy is needed to diagnose lymphoma. A surgeon removes a whole lymph node or part of one, or a wide needle takes a core of tissue. A pathologist then studies the cells under a microscope. T-cell lymphomas are uncommon and come in many types, so pinning down the exact type can take extra tests and expert review.
Lab tests look at markers on the cells (immunohistochemistry) and at the cells’ chromosomes. Tests for T-cell receptor gene changes can also help. Some markers point to a type. ALK, for example, separates ALK-positive from ALK-negative anaplastic large cell lymphoma.
Two types are closely tied to viruses. Adult T-cell leukemia/lymphoma is caused by the human T-cell leukemia virus type 1 (HTLV-1). In extranodal NK/T-cell lymphoma, the tumor cells almost always carry Epstein–Barr virus (EBV).
Staging shows where the lymphoma is. It often includes a PET scan, and a bone marrow biopsy when the result would change treatment. Blood tests may also check for HIV and hepatitis B and C before treatment. Types that start in the skin, such as mycosis fungoides, are staged and treated differently.
When transplant specialists are usually consulted
The U.S. consultation guidelines from NMDP and ASTCT list mature T-cell and NK-cell lymphomas for a transplant consultation at diagnosis or in first remission, and again at relapse. NMDP notes that most transplants for non-Hodgkin lymphoma use a person’s own cells, and a donor transplant is used in some cases of high-risk lymphoma that comes back or does not respond.
Read the guidanceLooking ahead
Outlook for T-cell lymphoma
Outlook varies a great deal by type. The National Cancer Institute says peripheral T-cell lymphoma, as a group, has a poor outlook. ALK-positive anaplastic large cell lymphoma usually does much better. Hepatosplenic T-cell lymphoma is among the types linked with worse survival. Most people with early mycosis fungoides, a skin type, have a normal life expectancy.
In a large international study of adults with T-cell and NK-cell lymphomas that were mostly not skin types, about 4 in 10 were alive 10 years after diagnosis. Most deaths happened in the first five years. For people alive at five years, the chance of reaching 10 years was 84 in 100.
In that study, age over 60 and being less able to manage daily activities were linked with lower survival. Risk scores such as the International Prognostic Index (IPI) also helped sort people by risk. Some people have an own-cell (autologous) transplant once first treatment has worked. European guidance recommends this for the main types, while NCI’s summary calls the evidence anecdotal. European guidance calls a donor transplant the only treatment that can cure lymphoma that has come back or never responded, for people well enough to have one.
About these numbers. Each one says which group of people it comes from, and the place and years where the source gives them. It describes what happened across that group, not what will happen to any one person. And a figure measured among people who had a transplant is not the same as the number of people who need one.
- 40%Alive 10 years after diagnosis
735 adults with peripheral T-cell or NK-cell lymphomas (mycosis fungoides and Sézary syndrome not included) diagnosed 2006–2018 and registered in the International T-cell Project, from the 19 centers that reported 10-year follow-up; median age 56; reported 2024
Read the source: Alive 10 years after diagnosis
This figure mixes many types, from ALK-positive ALCL to much harder types. It does not include mycosis fungoides or Sézary syndrome, and it cannot predict how any one person will do.
Common questions
What is T-cell lymphoma?
T-cell lymphomas are non-Hodgkin lymphomas that start in T cells or natural killer (NK) cells, two kinds of immune cell. They are less common than B-cell lymphomas. NCI says T-cell types make up less than 15% of non-Hodgkin lymphomas. Main types include peripheral T-cell lymphoma, anaplastic large cell lymphoma and angioimmunoblastic T-cell lymphoma. Mycosis fungoides and Sézary syndrome start in the skin.
Is T-cell lymphoma aggressive?
Many are. The National Cancer Institute says most T-cell types have worse outcomes than B-cell lymphomas, and peripheral T-cell lymphoma generally has a poor outlook. There are exceptions. ALK-positive anaplastic large cell lymphoma usually has a better outlook. Most people with early mycosis fungoides, a skin type, have a normal life expectancy.
What are the symptoms of T-cell lymphoma?
Common signs of non-Hodgkin lymphoma are swollen lymph nodes, fever, drenching night sweats, weight loss and feeling very tired. Some people have pain in the chest, belly or bones, or a rash or itchy skin. Skin types usually start as a red rash. These symptoms have many other causes, so a biopsy is needed to know for sure.
What is the survival rate for T-cell lymphoma?
It depends on the type. Some types, such as ALK-positive ALCL and early mycosis fungoides, do much better than average. In a large international study, most people who were alive five years after diagnosis were still alive at 10 years. The outlook section on this page gives the figures, with the groups they describe. No number can predict how one person will do.
Is T-cell lymphoma caused by a virus?
Two types are closely tied to viruses. Adult T-cell leukemia/lymphoma is caused by the human T-cell leukemia virus type 1 (HTLV-1). In extranodal NK/T-cell lymphoma, the tumor cells usually carry Epstein–Barr virus (EBV).
Is a stem cell transplant used for T-cell lymphoma?
Sometimes. Which kind depends on the type and how it responds. European guidance (EBMT, 2025) recommends an own-cell transplant in first remission for the main types. For some rarer, aggressive types, such as hepatosplenic, NK/T-cell and adult T-cell leukemia/lymphoma, it strongly recommends a donor transplant during first treatment. For lymphoma that comes back or never responds, the same guidance calls a donor transplant the only treatment that can cure it. It is used for people well enough to have one.
For your next appointment
T-cell lymphoma
From the Jada Bascom Foundation disease library, jadabascomfoundation.org. Printed .
Questions to bring to your care team
- Which type of T-cell lymphoma is it, and what does that change about my treatment?
- Did the tests check CD30, ALK or a virus such as HTLV-1 or EBV, and what did they show?
- Would an own-cell transplant after first treatment help in my case?
- When would you want me to meet a transplant team, and would a donor transplant ever be part of the plan?
- What is the goal of each treatment you are suggesting?
- How does a transplant compare with the other treatments on offer?
- Where can our family find support during treatment?
A one-page list to take to the next appointment, with room for notes.
Supporting someone with a diagnosisSupport for patients and families
These independent organizations offer information and support. JBF is not affiliated with them.
- Lymphoma Research Foundation US nonprofit devoted to lymphoma; it explains peripheral T-cell lymphoma and runs a helpline for patients and families.United States
- Lymphoma Action UK charity with a freephone helpline, live chat, monthly support meetings, peer buddies and free books for anyone affected by lymphoma.United Kingdom
- Lymphoma Canada Canadian charity offering free patient guides, peer mentoring, support groups, webinars and an ask-a-specialist service for people with lymphoma.Canada
Ways to help
Other patients need a donor.
A transplant for T-cell lymphoma usually uses the patient’s own cells, but thousands of other patients need a donor. For many of them, that donor is a stranger who joined a registry.
Join the registry
JBF points you to the official registry that serves your country. It explains who can join and what donation involves.
Support this work
Gifts to the Jada Bascom Foundation support donor-awareness education like this page, community outreach, drive planning and referrals to official registries.
Help a family find a donor
Our family guide explains practical ways to help someone who needs a donor. A registration drive can add many potential donors at once, for them and for others.
Keep learning
Understanding transplant
Short explainers on what a transplant is and what it means for a family.
Sources and further reading
- Adult Non-Hodgkin Lymphoma Treatment (PDQ), Patient Version
National Cancer Institute, 2024-08-22 - Non-Hodgkin Lymphoma
Lymphoma Research Foundation, Accessed 2026-09-24 - Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations
EBMT / Bone Marrow Transplantation, 2025-09-09 - Peripheral T-Cell Non-Hodgkin Lymphoma Treatment (PDQ), Health Professional Version
National Cancer Institute, Updated 2025-05-13; accessed 2026-09-26 - Long Term Outcome of Peripheral T Cell Lymphomas: 10-year Follow-Up of the International Prospective T Cell Project
British Journal of Haematology (Civallero et al., International T-cell Project), 2024-03-26 - HCT consultation timing guidelines: Non-Hodgkin lymphoma (NHL)
NMDP (with ASTCT), Accessed 2026-09-26 - Cutaneous T-cell Lymphoma
Cutaneous Lymphoma Foundation, Accessed 2026-09-26
