Non-Hodgkin's lymphoma

Non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of malignancies of the lymphoid system.

Clinical history depends on the type of lymphoma and stage at presentation.

Diagnosis is confirmed by tissue sampling (e.g., lymph node, bone marrow, blood, skin).

Diffuse large B-cell lymphoma is the most common type of lymphoma, based on annual incidence.

Treatment is based on the histological subtype and stage of the lymphoma; symptom severity informs decisions about when to start therapy.

R-CHOP-21 (rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisolone given on day 1 of a 21-day cycle) is the most commonly used chemotherapy regimen.

NHLs are a heterogeneous group of malignancies of the lymphoid system.[1]Armitage JO. Treatment of non-Hodgkin's lymphoma. N Engl J Med. 1993 Apr 8;328(14):1023-30. http://www.ncbi.nlm.nih.gov/pubmed/8450856?tool=bestpractice.com This heterogeneity (>30 entities) stems from the functions of the lymphoid arm of the immune system, which employs various types of lymphocytes to defend against external (infectious) and internal (neoplastic) threats. Neoplasms derive from lymphocyte B-cell progenitors, mature B-cells, T-cell progenitors, or mature T cells.

Malignant lymphoid cells retain many qualities of their normal counterparts (B cells to produce immunoglobulins; T cells to travel to extranodal sites such as skin and central nervous system).

This topic does not cover mycosis fungoides/Sézary syndrome. For more information on these subtypes, see Cutaneous T-cell lymphoma.