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Non-Hodgkin lymphoma (NHL) is a blood cancer with more than 60 subtypes. It occurs when a type of white blood cell called a lymphocyte changes and grows out of control.
Subtypes of NHL are often described by how quickly they grow.
- Indolent NHLs tend to grow slowly and cause fewer symptoms. Indolent NHL may come back as aggressive NHL.
- Aggressive NHLs tend to grow and spread quickly. They can cause severe symptoms.
Some subtypes have features of both indolent and aggressive disease.
Non-Hodgkin Lymphoma Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.
Understanding the Lymphatic System
Your lymphatic system is a network of tubes (lymphatic vessels) that collect fluid from around your body and carry it into your bloodstream to be recycled. The fluid (lymph) contains normal waste products from your tissues. It also contains lymphocytes and other immune cells.
Along the vessels are small, bean-shaped organs called lymph nodes. These nodes act as filters. They trap bacteria, viruses and damaged or diseased cells so your lymphocytes or other immune cells can destroy them.
You have several types of lymphocytes. NHL can affect any of them.
- B lymphocytes, also called B cells: These make antibodies. Antibodies attach to viruses and bacteria and to cells infected with a virus or bacteria. This is how other immune cells recognize and know to destroy them.
- T lymphocytes, also called T cells: These help destroy infected cells or tumor cells, or they attract or prompt other immune cells to do the same. Some T cells also help B cells make antibodies.
- Natural killer cells, also called NK cells: These scout for abnormal cells, including tumor cells, and destroy them.
Lymph tissue is found in other parts of your body too, including in your adenoids (glands in upper airway), tonsils, thymus, spleen, digestive tract and bone marrow. Lymphoma can affect any of these.
Subtypes of Non-Hodgkin Lymphoma
Physicians often group subtypes of NHL into two main categories: B-cell lymphomas and T-cell lymphomas. Each subtype of NHL acts differently, and each is treated differently. At Fred Hutch Cancer Center, we have physicians who specialize in NHL. They have a deep knowledge of NHL subtypes. Our experts know which therapies to use for each subtype and when to use them.
Non-Hodgkin Lymphoma Research at Fred Hutch
At Fred Hutch, our physicians and scientists have clinical trials for all stages of NHL, from early to advanced. We are studying chemotherapy regimens, targeted therapies, immunotherapies and blood and marrow transplantation. When your care team designs your treatment plan, they will give you the choice to join clinical trials that match your situation.
Learn about NHL research at Fred Hutch.
Causes of Non-Hodgkin Lymphoma
The exact cause of NHL is not known. But generally speaking, cancer happens because of changes (mutations) in cell DNA.
- DNA is the chemical that makes up your genes.
- Genes control when your cells grow, divide into new cells and die.
- DNA mutations can cause cells to grow abnormally and lead to cancer if:
- They turn on genes that help cells grow and divide (oncogenes).
- They turn off genes that slow cell division or make cells die when they should (tumor-suppressor genes).
- They turn off genes that help fix problems in DNA (DNA repair genes).
Studies show that certain factors are linked to increased risk. Some of these risk factors are things you can’t change, such as getting older, having a family history of NHL or having certain autoimmune conditions. Other factors relate to your lifestyle, so you may be able to change them. For example, excess body weight may increase risks.
Learn more about NHL risk and prevention.
If you have any signs or symptoms that you worry might be from lymphoma, talk with your primary care provider. Many NHL symptoms can be caused by other conditions. Whatever the cause, it’s important to find out so you can get treatment to help.
If you’re concerned about risk, here are some questions you may want to ask:
- Do I have any risk factors for NHL?
- Is there any reason to think I’m at higher risk than the average person?
- If I am at higher risk, what does this mean for me? Is there anything I can do to lower my risk?
If you have symptoms that concern you, here are some questions to ask:
- What could be causing my symptoms?
- Do these symptoms mean I might have a serious condition?
- How can we find out the cause? Do I need any tests?
- What should I do if my symptoms don’t get better or if I get new symptoms?
NHL can happen throughout life, even in childhood. But most people diagnosed with NHL — almost 30% — are between 65 and 74 years old. The typical age range may be different for some subtypes of NHL. Some subtypes are more common earlier in life.
When physicians and scientists talk about cancer survival rates, they typically mean the percentage of people expected to survive their cancer for at least five years after being diagnosed. (The rate doesn’t include the risk of dying during that time for some other reason.) Overall, the relative five-year survival rate for NHL in the United States is 74.3%, according to the National Cancer Institute.
This rate comes from looking at a large, diverse group of people. The chance of surviving cancer at least five years can vary greatly from one person to another. It depends on many factors, like how far the cancer has spread or, in the case of NHL, if it’s an indolent or aggressive subtype. Your Fred Hutch care team can explain how statistics like survival rates might apply to you.
Learn about NHL survival rates.
NHL starts when lymphocytes (certain kinds of white blood cell) grow out of control. Normally, cells in the body grow and multiply to form new cells as the body needs them. When cells get old or damaged, they die and are replaced. Sometimes, this normal process breaks down. Abnormal or damaged cells grow and multiply when they shouldn’t, forming tumors. Some tumors are cancer, and others are benign (noncancerous).
NHL spreads by growing into, or invading, nearby tissues or by traveling through the lymph or blood to distant parts of the body. Then new tumors can form in these places.