Nonhodgkin lymphoma i page 1 table of contents 2 introduction 4 here to help 7 nonhodgkin lymphoma overview 9 incidence, causes and risk factors 11 signs and symptoms 12 diagnosis 14 staging 17 treatment overview 22 treatmentaggressive subtypes, part 1 25 treatmentaggressive subtypes, part 2 27 treatmentindolent subtypes 33 side effects of treatment for nonhodgkin lymphoma. Althoughtheclonalbcelloriginofbothlymphocytepredominant and classic hl was recently demonstrated 2, thus enabling the term hodgkin disease to be changed to hodgkinlymphoma 3,thepathogenicmechanismsofthis lymphoma are still largely unknown. Lymphoma and chronic lymphocytic leukemia staging systems bcca lymphoma, hodgkin and nonhodgkin 1982 stage involvement 1 single lymph node region 1 or one extralymphatic site 1e. No m category exists for hodgkin and nonhodgkin lymphoma clinical group i involvement of a single lymphatic site i. Extranodal e designation is used only for limited extranodal disease in the absence of nodal involvement ie or in patients with stage ii disease and direct extension to a nonnodal. If a biopsy confirms a diagnosis of nonhodgkin lymphoma, further testing will be required to check how far the lymphoma has spread. The systems are similar, and lugano is based on the ann arbor system. Follicular nonhodgkin lymphoma grades 3a and 3b have a similar outcome and appear incurable with anthracyclinebased therapy.
They are cancers of the lymphatic tissues mainly lymph. Staging is a way of describing how far nonhodgkin lymphoma has spread throughout the body. For example, staging for hodgkin lymphoma based on the ann arbor staging system means that a patient with stage iib hodgkin lymphoma has. Staging is a way of describing how far hodgkin lymphoma has spread throughout the body. Stages of nonhodgkin lymphoma canadian cancer society. Many lymphoma staging systems for both hodgkin lymphoma and nonhodgkin lymphoma have been developed the most widely used currently is the lugano staging classification, which also separately defines criteria for response to treatment assessed by petct or by ct alone patients having undergone immunomodulatory therapy may also be assessed by a modification of the lugano criteria. More than 100 recognized authorities from all parts of the world provide comprehensive, current information on every aspect of hodgkin lymphoma, including etiology, epidemiology, biology, pathology, evaluation, staging, treatment, and followup. Nonhodgkin lymphoma nhl is a catchall term for lymphomas that are not of the hodgkin subtype. Treatment options for stage 2 nonhodgkin lymphoma depend on whether the disease is diagnosed as indolent or aggressive. A diagnosis of stage 2 nonhodgkin lymphoma means the disease is somewhat limited, and your doctor may opt not to treat it all, asking instead for you to come in for periodic monitoring checkups, or treat extremely targeting regions with radiation. Two or more nodal sites or a localized extranodal site plus draining sites plus either performance status. Lymphocytepredominant hodgkin lymphomafirstline treatment ongoing clinical trials will help clarify the role of a watchandwait strategy or systemic therapy, including anthracycline epirubicin or doxorubicin, bleomycin, and vinblastinebased chemotherapy or antibodybased approaches.
The two major types of lymphoma are hodgkin lymphoma hl and non hodgkin lymphoma nhl. Instructions for hodgkins and nonhodgkins lymphoma pre. Nonhodgkins lymphoma is attributed a level of stage 1 through stage 4 using the ann arbor staging system. A staging system is a way for the cancer care team to sum up the extent of a cancers spread. Hodgkin lymphoma, sometimes called hodgkin disease, is a type of lymphoma a general term for cancer of the lymphatic system the various lymph glands around the body. Nonhodgkin lymphoma early detection, diagnosis, and staging. Nonhodgkins lymphoma is the sixth most common cancer in the uk. What are the treatment options for stage 2 nonhodgkin. Hodgkin lymphoma staging leukemia and lymphoma society. Hodgkin lymphoma is a rare cancer accounting for approximately 0. This determines the treatment options and the survival estimation. Lymphoma is a general name for a group of cancers that affect the lymphatic system.
The traditional staging for hodgkin lymphoma and nonhodgkin lymphoma was initially presented at the ann arbor symposium on staging of hodgkin lymphoma, april, 1971. Knowing the stage helps your doctor work out the best treatment for you. Bm bx no longer indicated for routine staging of hl and most dlbcl. Radiation oncologyhodgkinstaging wikibooks, open books. Apart from these two conditions, the systematic use of pet in staging is not based on any international recommendation. Hodgkin and nonhodgkin lymphomas of all sites excluding mycosis fungoides and sezary disease discontinued sitespecific factors.
There is also a hodgkins lymphoma variant of richter transformation. For limited stage i or ii hl that affects an organ outside of the lymph system. The major indication of trephine in lymphomas is for staging purposes. However, this is two different lymph node chains according to staging. It can spread to nearly any other part of the body. Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family. The most effective firstline treatment for earlystage follicular lymphoma. Some early cancers may have signs and symptoms that can be noticed, but that is not always the case. Unlike other cancers, therapy and prognosis are not based solely on the stage at which the disease is diagnosed but rather are determined by the lymphoma type. The american cancer society s most recent estimates for non hodgkin s lymphoma are for 2019 about 74,200 people 41,090 males and 33,110 females will be diagnosed with nhl. The ann arbor staging system has for many years been widely.
Pathogenesis, diagnosis, and treatment of composite. Your doctor needs to know the extent stage of nonhodgkin lymphoma to plan the best treatment. What is the life expectancy of stage 3 nonhodgkins lymphoma. To fight infection, your lymph system extends throughout most of your body, which is why lymphoma can spread easily. For the ann arbor system, clinical staging includes all of the noninvasive procedures. You will find some helpful links to other areas of cancer. National cancer institute modified staging for intermediate and high grade lymphomas i. Pediatric nonhodgkin lymphoma staging system recently, a multidisciplinary expert panel proposed a revised inhlss to address some of the shortcomings of the st. The most common staging systems for nonhodgkin lymphoma nhl are the ann arbor and lugano staging systems. Nonhodgkin lymphoma staging virginia oncology hematology.
Lymphoma nos and nonhodgkin lymphoma can be found under the. The two main categories of lymphomas are hodgkins lymphomas hl and the nonhodgkin lymphomas nhl. Cd68positive tumorassociated macrophages predict unfavorable treatment outcomes in classical hodgkin lymphoma in correlation with interim fluorodeoxyglucosepositron emission tomography assessment. The term nonhodgkin lymphomas is applied to a group of diverse neoplasms that arise in the reticuloendothelial system.
Nonhodgkin s lymphomas nhls are malignant proliferations of the lymphoid tissues that can be distinguished from hodgkins lymphoma see chapter 14 by a variety of clinical and. Nonhodgkin lymphoma nhl consists of a diverse group of malignant neoplasms variously derived from b cell progenitors, t cell progenitors, mature b cells, mature t cells, or rarely natural killer cells. Non hodgkin lymphoma i page 1 inside this booklet 2 introduction 2 lymphoma 2 about non hodgkin lymphoma 6 signs and symptoms 8 diagnosis 10 staging 15 treatment overview 20 treatment of aggressive subtypes 28 treatment of indolent subtypes 36 refractory or relapsed non hodgkin lymphoma nhl 38 research and clinical trials 42 side effects of treatment. Guideline cheson bd, fisher ri, barrington sf, cavalli f, schwartz lh, et al. The staging system used for hodgkin lymphoma is the lugano classification, which is based on the older ann arbor system.
Introduction, implementation and analysis with lymphoma related data shuo chi, cstone pharmaceutical introduction lymphoma is a group of blood cancers that develop from lymphocytes. Nonhodgkin lymphoma has four different stages as classified by the ann arbor staging system. Stages i and ii are considered earlystage lymphoma and stages iii and iv are considered advancedstage lymphoma. Historically it has been considered to combine adverse features of both low grade. This consensus document on management of non hodgkins lymphoma. It is a heterogeneous group of malignancies in terms of histology, clinical presentation, and prognosis. A predictive model for aggressive nonhodgkins lymphoma. Non hodgkins lymphoma diagnosis and staging see online here nonhodgkins lymphomas nhl are hematological malignancies with high prevalence worldwide accounts for about 4 % of all cancer cases and 2. The interlymph nonhodgkin lymphoma subtypes project. Hodgkins and non hodgkins lymphoma prehsct data form 2018 document number. The definitive text on hodgkin lymphoma is now in its thoroughly revised, updated second edition.
Key statistics for non hodgkin lymphoma non hodgkin lymphoma nhl is one of the most common cancers in the united states, accounting for about 4% of all cancers. Pdf nonhodgkin lymphoma nhl is the sixth most common cancer in the uk and represents a heterogenous. See 2008 who classification for further information on subtypes. Non hodgkin lymphoma nhl they behave, spread, and respond to treatment differently, so its important for you to know which one you have. In addition to combinations of a hodgkins lymphoma and a nonhodgkin lymphoma, composite lymphomas can also consist of two distinct types of nonhodgkin lymphoma occurring concurrently in a patient. Causes of nonhodgkins lymphoma the exact cause of nonhodgkins lymphoma remains unknown. However, research has focused on some factors that may contribute to the development of lymphoma, including genetic factors, impaired immune system and viruses, such as hiv or ebv. The most popular classification system for staging non hodgkins lymphoma is the ann arbor staging system. Pathology outlines staging of hodgkin and nonhodgkin. The macmillan cancer support website has detailed information on the different types of nonhodgkin lymphoma. Involvement of two lymph node sites near each other for example, enlarged lymph nodes in the neck and near the collarbone, or in the neck and the armpit fever, excessive sweating and weight loss. As this classification gains more acceptance, ajcc will consider its use in the future for uniformity in management of. Net that provide information about cancer care and treatment.
To learn about the other type, see non hodgkin lymphoma2. Recommendations for initial evaluation, staging, and response assessment of hodgkin and nonhodgkin lymphoma. According to the american cancer society, stage 3 indicates that the lymphoma is in the lymph nodes on both sides of the diaphragm. The classification, staging and prognosis of nhl, including. The tests described here help show how far nonhodgkin lymphoma has spread.
St jude murphy staging used in childhood nonhodgkin lymphoma. Significant improvements in our understanding of the biology. Types of nonhodgkins lymphoma there are more than 30 different. There are more than 30 types of nonhodgkin lymphoma.
The site code that should be assigned is still c77. Diagnosing nonhodgkins lymphoma and the precise subtype is challenging, and optimising the diagnostic process is central to improved management. The lymph system to understand what hodgkin lymphoma is, it helps to know about the lymph system3. Pet is indicated in diffuse large b cell lymphomas dlbcl and hodgkins disease. Brief summaries of two commonly encountered types of nonhodgkin lymphomadiffuse histiocytic lymphoma and nodular, lymphocytic, poorly differentiated lymphoma rappaport et al 1 classificationillustrate some of the variability of features and natural. Staging and monitoring in the treatment of lymphomas sciencedirect. Non hodgkin lymphoma early detection, diagnosis, and staging 1. Once the non hodgkins lymphoma diagnosis is made, the physician needs to stage the disease. Medical history, lifestyle, family history, and occupational risk factors for diffuse large bcell lymphoma. There are many different subtypes of the disease, with markedly different clinical courses and requirements for therapy. This process is called staging and it helps your health care team recommend the best treatment for you.
In the united states in 20, about 9,290 persons were expected to be diagnosed with hodgkin lymphoma. Two or more lymph node regions involved on the same side of the diaphragm the muscle that controls breathing and. Staging is a careful attempt to find out what parts of the body are affected by the disease. Nonhodgkin lymphoma nhl represents the most common hematological malignancy in adults worldwide and accounts for approximately 90% of all diagnosed. Nonhodgkins lymphoma, or nhl, develops when cancerous cells crowd out healthy ones in the tissues and organs that make up the immune system, your bodys line of defense.