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Non-Hodgkin lymphoma

Non-Hodgkin lymphoma

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Encyclopedia
The non-Hodgkin lymphomas (NHLs) are a diverse group of blood cancers
Hematological malignancy
Hematological malignancies are the types of cancer that affect blood, bone marrow, and lymph nodes. As the three are intimately connected through the immune system, a disease affecting one of the three will often affect the others as well: although lymphoma is technically a disease of the lymph...

 that include any kind of lymphoma
Lymphoma
Lymphoma is a cancer in the lymphatic cells of the immune system. Typically, lymphomas present as a solid tumor of lymphoid cells. Treatment might involve chemotherapy and in some cases radiotherapy and/or bone marrow transplantation, and can be curable depending on the histology, type, and stage...

 except Hodgkin's lymphoma
Hodgkin's lymphoma
Hodgkin's lymphoma, previously known as Hodgkin's disease, is a type of lymphoma, which is a cancer originating from white blood cells called lymphocytes...

s. Types of NHL vary significantly in their severity, from indolent to very aggressive.

Lymphomas are types of cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 derived from lymphocyte
Lymphocyte
A lymphocyte is a type of white blood cell in the vertebrate immune system.Under the microscope, lymphocytes can be divided into large lymphocytes and small lymphocytes. Large granular lymphocytes include natural killer cells...

s, a type of white blood cell
White blood cell
White blood cells, or leukocytes , are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a...

. Lymphomas are treated by combinations of chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

, monoclonal antibodies, immunotherapy
Immunotherapy
Immunotherapy is a medical term defined as the "treatment of disease by inducing, enhancing, or suppressing an immune response". Immunotherapies designed to elicit or amplify an immune response are classified as activation immunotherapies. While immunotherapies that reduce or suppress are...

, radiation
Radiation therapy
Radiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...

, and hematopoietic stem cell transplantation.

Non-Hodgkin lymphomas were classified according to the 1982 Working Formulation
Working Formulation
The Working Formulation is an obsolete classification of non-Hodgkin lymphomas published in 1982. It has since been replaced by other lymphoma classifications, the latest published by the WHO in 2008, but is still used by cancer agencies for compilation of lymphoma statistics.Low Grade*Malignant...

 which recognizes 16 types. The Working Formulation is now considered obsolete, and the classification is commonly used primarily for statistical comparisons with previous decades. The Working Formulation has been superseded twice.

The latest lymphoma classification, the 2008 WHO
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 classification, largely abandoned the "Hodgkin" vs. "Non-Hodgkin" grouping. Instead, it lists over 70 different forms of lymphomas in four broad groups.

History


Hodgkin lymphoma (H, Hodgkin disease), described by Thomas Hodgkin
Thomas Hodgkin
Thomas Hodgkin was a British physician, considered one of the most prominent pathologists of his time and a pioneer in preventive medicine. He is now best known for the first account of Hodgkin's disease, a form of lymphoma and blood disease, in 1832...

 in 1832, was the first form of lymphoma described and defined. Other forms were later described and there was a need to classify them. Because Hodgkin lymphoma was much more radiation-sensitive than other forms, its diagnosis was important for oncologists and their patients. Thus, research originally focused on it. The first classification of Hodgkin lymphoma was proposed by Robert J. Luke in 1963.

While consensus was rapidly reached on the classification of Hodgkin lymphoma, there remained a large group of very different diseases requiring further classification. The Rappaport classification, proposed by Henry Rappaport in 1956 and 1966, became the first widely accepted classification of lymphomas other than Hodgkin. Following its publication in 1982, the Working Formulation
Working Formulation
The Working Formulation is an obsolete classification of non-Hodgkin lymphomas published in 1982. It has since been replaced by other lymphoma classifications, the latest published by the WHO in 2008, but is still used by cancer agencies for compilation of lymphoma statistics.Low Grade*Malignant...

 became the standard classification for this group of diseases. It introduced the term non-Hodgkin lymphoma (NHL) and defined three grade
Grading (tumors)
In pathology, grading is a measure of the cell appearance in tumors and other neoplasms. Some pathology grading systems apply only to malignant neoplasms ; others apply also to benign neoplasms. The neoplastic grading is a measure of cell anaplasia in the sampled tumors arising from the...

s of lymphoma.

However, NHL consists of 16 different conditions that have little in common with each other. They are grouped by their aggressiveness. Less aggressive non-Hodgkin lymphomas are compatible with a long survival while more aggressive non-Hodgkin lymphomas can be rapidly fatal without treatment. Without further narrowing, the label is of limited usefulness for patients or doctors.

Modern usage of term


Nevertheless, the Working Formulation and the NHL category continue to be used by many. To this day, lymphoma statistics are compiled as Hodgkin's vs non-Hodgkin lymphomas by major cancer agencies, including the National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...

 in its SEER
Surveillance Epidemiology and End Results
The Surveillance Epidemiology and End Results Program of the National Cancer Institute is a source of information on cancer incidence and survival in the United States.-The Program:...

 program, the Canadian Cancer Society
Canadian Cancer Society
The Canadian Cancer Society is a national, community-based charitable organization of volunteers whose mission is to eradicate cancer and enhance the quality of life of those living with the disease....

 and the IARC
International Agency for Research on Cancer
The International Agency for Research on Cancer is an intergovernmental agency forming part of the World Health Organisation of the United Nations....

.

See also

  • Lymphoma
    Lymphoma
    Lymphoma is a cancer in the lymphatic cells of the immune system. Typically, lymphomas present as a solid tumor of lymphoid cells. Treatment might involve chemotherapy and in some cases radiotherapy and/or bone marrow transplantation, and can be curable depending on the histology, type, and stage...

    , for information about all forms of NHL as well as Hodgkin's lymphoma
  • Chemotherapy
    Chemotherapy
    Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

    , for information on the standard of care of all forms of non-Hodgkin lymphomas.
  • CHOP-R for the most common chemotherapeutic regimen for lymphoma.

External links