hematology and oncology
Non Hodgkin Lymphomas
Introduction
Non-Hodgkin lymphomas are a heterogeneous group of disorders involving malignant monoclonal proliferation of lymphoid cells in lymphoreticular sites, including lymph nodes, bone marrow, the spleen, the liver, and the gastrointestinal tract. Presenting symptoms usually include peripheral lymphadenopathy. However, some patients present without lymphadenopathy but with abnormal lymphocytes in circulation. Disease is likely to be disseminated at the time of presentation, and diagnosis is usually based on lymph node or bone marrow biopsy or both. Management strategies may include watch and wait, chemotherapy, targeted drugs (eg, kinase inhibitors), and immunotherapies (eg, monoclonal antibodies, chimeric antigen receptor T cells); occasionally, radiation therapy is added. With few exceptions, stem cell transplantation is usually reserved for patients with aggressive lymphomas after incomplete remission or relapse. (See also Overview of Lymphoma .) Non-Hodgkin lymphoma is more common than Hodgkin Lymphoma . It is the 6th most common cancer in the US and represents 4% of all new cancers in the US each year and 3% of all cancer deaths. Over 80,000 new cases are diagnosed annually in all age groups and there are about 20,000 deaths. Non-Hodgkin lymphoma is not one disease but rather a category of lymphocyte cancers with a number of subgroups largely divided into aggressive and indolent types. Incidence increases with age (median age, 67 years). 