Important Concepts in Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma (NHL) is a heterogeneous group of diseases that together accounts for 66,000 new cases each year in the United States, making it the fifth most common cancer. Over four dozen discrete NHL subtypes are now recognized, each characterized by unique biology with implications for diagnosis and therapy. Clinically, NHLs can be generally classified by their cell of origin (B-cell or T-cell), as well as by clinical behavior, which may be considered indolent (eg, follicular lymphoma), aggressive (eg, diffuse large Bcell lymphoma) or highly aggressive (eg, Burkitt lymphoma). Aggressive and highly-aggressive NHLs are often curable diseases; the goal of therapy is complete disease eradication. In contrast, indolent NHLs are usually incurable with standard therapies, but given long natural histories that may be measured in years to decades, treatment is used as needed to control symptoms while prolonging overall survival. Over the past decade, diagnostics and therapies for NHL have evolved rapidly and have been at the vanguard for the development of novel targeted anti-cancer therapies that can improve outcomes for lymphoma patients and ultimately minimize broad toxicities of chemotherapy. Addressing Diagnosis, Treatment, & Supportive Care Lymphoma subtypes may be difficult to diagnose, but accurate classification is critical in selecting appropriate therapy. Clinicians must therefore collaborate closely with pathologists, ideally with expertise in hematopathology. Once patients are diagnosed, treatment will further depend on...