This page was reviewed under our medical and editorial policy by Maurie Markman, MD, President, Medicine & Science
This page was updated on July 20, 2022.
Non-Hodgkin lymphoma is the most common type of blood cancer, with more than 80,620 newly diagnosed cases expected in the United States in 2024, according to the American Cancer Society. The disease is sometimes called non-Hodgkin’s lymphoma, NHL or just “lymphoma.” It develops in white blood cells, called lymphocytes, which are part of the body’s immune system.
Non-Hodgkin lymphoma is complex. That’s why it’s important to consult with an experienced team of cancer doctors and clinicians trained to identify each patient’s specific cancer type and develop a treatment plan tailored to his or her individual needs. At City of Hope, our medical oncologists, hematologist-oncologists and other experts have years of experience delivering standard-of-care and precision cancer treatments available to treat non-Hodgkin lymphoma.
This overview will cover the basic facts about non-Hodgkin lymphoma, including:
If you believe you may be experiencing symptoms of non-Hodgkin lymphoma and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for your non-Hodgkin lymphoma diagnosis and treatment plan, call us or chat online with a member of our team.
Non-Hodgkin lymphoma is a cancer that forms in the lymph system, which filters wastes and toxins and carries immune cells to different parts of the body via a network of vessels, tissues and organs—including the spleen, tonsils and thymus.
Non-Hodgkin lymphoma that infiltrates sites other than lymph nodes is called extranodal. Some of the most common extranodal sites for the disease are the stomach, Waldeyer ring, central nervous system, lung, bone and skin. In non-Hodgkin lymphoma, the spleen is also considered an extranodal site.
Lymphoma may affect either the B lymphocytes (B-cells) or T lymphocytes (T-cells). B-cells help produce antibodies to protect the body against germs such as bacteria and viruses. The antibodies fight infection by attaching to the germs, marking them for destruction by other parts of the immune system. T-cells may either destroy germs or abnormal cells, or they may help boost or slow the activity of other immune system cells, according to the American Cancer Society.
A second type of lymphoma, Hodgkin lymphoma, is far less common cancer than non-Hodgkin lymphoma, accounting for fewer than 10,000 new lymphoma cases each year. The main difference between non-Hodgkin lymphoma and Hodgkin lymphoma is the type of lymphocytes affected. Hodgkin lymphoma is marked by oversized B-cells called Reed-Sternberg cells, which are not present in non-Hodgkin lymphoma. Hodgkin lymphoma is usually diagnosed at a younger age, while a majority of non-Hodgkin lymphoma cases are diagnosed in people over 55, with the cancer often at a more advanced stage.
Non-Hodgkin lymphoma is different than leukemia, another blood cancer. While lymphoma tends to affect the lymph nodes and related tissues, leukemia affects the blood and bone marrow. Lymphoma, like leukemia, may appear in the bloodstream as a form of liquid tumor or liquid cancer, but lymphoma is frequently detected after it forms a solid mass of cancerous cells that have built up in a lymph node, gland or organ.
Non-Hodgkin lymphoma is caused by changes in cell DNA. Some of these changes may be genetic, some may develop during a person’s lifetime due to an external influence, and still others may occur for no known reason. Gene changes that lead to non-Hodgkin lymphoma are usually acquired during a person’s lifetime, commonly as a result of exposure to:
Age is also a major risk factor for non-Hodgkin lymphoma. Researchers believe this is because gene mutations occur more often as we get older. Other risk factors for non-Hodgkin lymphoma include a family history of lymphoma and changes in the immune system due to:
People with weakened immune systems are at greater risk of getting the disease. It’s more typical in men than women and more common in whites than African Americans. More than three-quarters of new cases are diagnosed in individuals over the age of 55, although it may also affect people in their 20s or 30s.
"I called City of Hope right away and made an appointment. Within the next week, I was diagnosed with non-Hodgkin lymphoma, staged, given my treatment options and assured that I was not alone in my fight. I was on a team now—which I was to be a big part of—and we were going to do everything possible to beat this disease."
Non-Hodgkin lymphoma is classified into more than 30 types depending on the kind of lymphocyte—either B-cells or T-cells—involved. The disease is then further categorized by other factors, including whether the cancer is fast- or slow-growing.
The main types of non-Hodgkin lymphoma include:
Symptoms for non-Hodgkin lymphoma may include:
Tools and procedures for diagnosing non-Hodgkin lymphoma may include:
Learn more about diagnostic procedures for non-Hodgkin lymphoma
Treatment for non-Hodgkin lymphoma may include:
The impact non-Hodgkin lymphoma has on a patient depends largely on the type of the disease and the treatment prescribed. Because lymphoma affects B-cells or T-cells, the patient may have difficulty fighting off infection.
Treatments such as high-dose chemotherapy and stem cell transplantation often cause side effects, such as nausea, weight loss and a compromised immune system. Because lymphoma affects the lymphatic system, another symptom of non-Hodgkin lymphoma that may occur is lymphedema, which is swelling caused by a buildup of lymphatic fluid.
At City of Hope, we know that non-Hodgkin lymphoma and its treatment may cause stress on your musculoskeletal system, as well as aches and pains in your neck and/or back, headaches and difficulty walking. The disease also may affect physical functioning and energy.
Our whole-person care model is designed to support patients throughout the treatment journey. Your care team may recommend radiation therapy to relieve pain and discomfort caused by an enlarged spleen or swollen lymph nodes, for example, and our supportive care clinicians may recommend services to help manage lymphedema, pain and other non-Hodgkin lymphoma-related side effects.
Supportive care therapies that may be recommended to help patients with non-Hodgkin lymphoma stay strong and maintain their quality of life include: