Lymphoma Cancer Statistics 

In 2015, there are expected to be 80,900 new cases of lymphoma diagnosed in the US (9,050 cases of HL, 71,850 cases of NHL). 

There are an estimated 761,659 people living with, or in remission from, lymphoma in the US. (177,526 with Hodgkin lymphoma and 584,133 with non-Hodgkin lymphoma).

The five-year survival rate for people with HL has more than doubled, from 40 percent in the sixties to 87.7 percent in 2004-2010. The five-year survival rate for people with NHL has risen from 31 percent in the sixties to 71.4 percent in 2004-2010.

In 2015, 20,940 people are expected to die from lymphoma (1,150 from HL, 19,790 from NHL).

What causes Lymphoma Cancer? 

The cause of lymphoma is often a random event. However there are certain conditions that can increase the risk to develop lymphoma. 

Risk factors for NHL include some chemicals used in agriculture, nuclear radiation exposure, immune deficiency, autoimmune disease, and certain viral and bacterial infections such as Helicobacter or Epstein Barr Virus infections. 

Risk factors for Hodgkin lymphoma include infectious mononucleosis (Epstein-Barr virus infection), and age, typically people in their 20s, and people over the age of 55 years.

What are early symptoms of Lymphoma Cancer? 

Early symptoms of lymphoma can be deceiving, very similar to common viral illnesses, which can delay the diagnosis. They may involve painless swelling of lymph nodes in the neck, armpits, groin or abdomen. However, some people do not experience any detectable swelling in any part of the body. Symptoms may include night sweats, fevers, weight loss, unusual itching, or fatigue. As lymphoma can spread rapidly to other parts of the body numerous symptoms may occur. 

How does my doctor know I have Lymphoma Cancer? 

There is no screening program for lymphoma. It is only diagnosed when patients presents with persistent signs and symptoms. A thorough investigation includes taking a history, a physical examination, laboratory tests, scans (CT scans that show the size of tumor masses and PET scans that show how active a lymphoma may grow), and biopsies.

Lymphoma is diagnosed by a lymph node biopsy followed by an examination under the microscope and specialty tests such as immune-phenotyping, flow cytometry, fluorescence in situ hybridization testing, and gene-mutation testing. 

These tests should be done by an expert hemato-pathologist very experienced in the diagnosis of lymphoid/hematological malignancies. This is highly relevant as treatments for different lymphoma sub-types differ. In order to maximize cure rates and improve outcomes a correct, precise diagnosis and an appropriate treatment plan are absolutely necessary. 

What does Classification and Staging of my Lymphoma Cancer mean? 

Lymphomas are any cancers of the lymphatic tissues. They are distinguished/classified by the World Health Organization (WHO) system, using the latest information on the appearance and growth pattern of the lymphoma cells and genetic features, including whether or not it is a Hodgkin lymphoma, a T-cell or B-cell lymphoma, and the site from which the lymphoma arises.

Hodgkin lymphoma is marked by the presence of a type of cell called the Reed–Sternberg cell.

Non-Hodgkin lymphomas, which are defined as being all lymphomas except Hodgkin lymphoma, are more common than Hodgkin lymphoma. A wide variety of lymphomas are in this class, and the causes, the types of cells involved, and the prognosis vary by type. The incidence of non-Hodgkin lymphoma increases with age. It is further divided into several subtypes.

Of the over 66 forms of lymphoma, some are categorized as indolent (e.g. follicular lymphoma) and are compatible with a long life, whereas other forms are aggressive (e.g. Burkitt lymphoma or Diffuse Large B-cell lymphoma), causing rapid deterioration and death. However, most of the aggressive lymphomas respond well to treatment and many are curable. 

Aggressive non-Hodgkin lymphomas progress rapidly. They make up about 60 percent of all NHL cases in the United States. 

Aggressive NHL subtypes include:

Indolent non-Hodgkin lymphoma subtypes progress slowly. They make up about 30 percent of all NHL cases in the United States. 

Indolent NHL subtypes include:

What are treatments for Lymphoma Cancer? 

Prognoses and treatments are different for Hodgkin and the different forms of NHL. As a general rule, the faster a lymphoma grows the more sensitive to chemotherapy and curable it can be. Many lymphomas may be curable if detected in early stages.

Low-grade lymphomas
Many low-grade lymphomas remain indolent for many years and treatment is only initiated if patients become symptomatic. Patients with these types of lymphoma can live near-normal lifespans, but the disease is incurable.
If needed, initial treatment choices include single agent Rituximab, chemo-immunotherapy (e.g. Bendamustine + Rituximab), or clinical trials.

High-grade lymphomas
The majority of high grade NHL can be cured with R-CHOP based regimen (R-CHOP, dose adjusted EPOCH-R). In the group of patients who relapse, most relapse within the first two years, and the relapse risk drops significantly thereafter. For those patients high-dose chemotherapy followed by autologous stem cell transplantation is a proven, still potentially curable approach.

Hodgkin lymphomas
Hodgkin lymphoma typically is treated with chemotherapy with a continued declined role of radiotherapy. The most accepted standard chemotherapy regimen is ABVD. Encouragingly, patients who relapse after ABVD can still be potentially cured by an autologous stem cell transplantation. 

New treatment strategies in lymphoma
Lymphomas are a very heterogeneous group of malignancies. Individual cases harbor over 1000 genetic alterations/mutations, presenting the challenge of how to separate important “driver“- from inconsequential “passenger”-mutations. Over 100 novel anti-lymphoma targeted agents are in clinical development and some of them will be the building blocks of rational, more effective, and better tolerated treatment algorithms for lymphoid malignancies.

At UCLA, we make the most promising novel agents and combination-regimen available for lymphoma patients. We focus not only on relapsed disease, but have a strong emphasis on novel front-line treatments in an effort to improve lymphoma cure rates and management. Having reached the limits of standard chemo-immunotherapy, and considering all available regimens, clinical trials are offering now the best options for improved outcomes of patients with lymphoid malignancies. 

Patients should consider all options available to them, including clinical trials, before making treatment decisions. We conduct trials at UCLA main campus, at our regional satellite sites, as well as in the UCLA-affiliated community-practice network TRIO-US.