hematology and oncology
Non Hodgkin Lymphomas
Classification of Non Hodgkin Lymphomas
Pathologic classification of non-Hodgkin lymphoma continues to evolve, reflecting new insights into the cells of origin and the biologic bases of these heterogeneous diseases. The2016 WHO classificationis valuable because it incorporates immunophenotype, genotype, and cytogenetics, but numerous other systems exist (eg, Lyon classification). Non-Hodgkin lymphomas are commonly also categorized as indolent or aggressive: Indolent: Slowly progressive and responsive to therapy but not typically curable with standard approaches Aggressive: Rapidly progressive but responsive to chemotherapy and often curable , non-Hodgkin lymphoma is almost always aggressive. Follicular and other indolent lymphomas are unusual. The treatment of these aggressive lymphomas ( Burkitt Lymphoma , diffuse large B cell, and lymphoblastic lymphoma) presents special concerns, including gastrointestinal tract involvement (particularly in the terminal ileum); meningeal spread (requiring cerebrospinal fluid prophylaxis or treatment); and other sanctuary sites of involvement (eg, testes, brain). In addition, with these potentially curable lymphomas, treatment of adverse effects as well as outcome must be considered, including late risks of secondary cancer, cardiorespiratory sequelae, fertility preservation, and developmental consequences. 