What Is the Survival Rate for Non-Hodgkin Lymphoma?

Non-Hodgkin lymphoma (sometimes called NHL, or just lymphoma) is a cancer of the lymphocytes, which are cells that are part of the body's immune system. In lymphoma, lymphocytes become abnormal and grow out of control and can travel throughout the body and collect in the lymph nodes, causing them to swell. 

Non-Hodgkin lymphoma is different from Hodgkin lymphoma, which behaves, spreads, and responds to treatment differently.

Symptoms of non-Hodgkin lymphoma include:

• One or more large, swollen lymph nodes
• Chills
• Tiredness (fatigue)
• Swollen abdomen
• Feeling full after only a small amount of food
• Chest pain or pressure
• Shortness of breath
• Cough
• Severe or frequent infections
• Easy bruising or bleeding

Some people with Non-Hodgkin lymphoma have what are known as B symptoms:

• Fever (which can come and go over several days or weeks) without an infection
• Drenching night sweats that soak through clothing
• Weight loss without trying (at least 10% of body weight over 6 months)

Causes of non-Hodgkin lymphoma include:

• Genetic mutations
• Changes in the immune system
• Immune deficiencies (due to inherited conditions, certain drug treatments, organ transplants, or HIV infection) 
• Autoimmune diseases 
• Chronic infections 

Risk factors for developing non-Hodgkin lymphoma include:

• Age over 60
• Gender: tends to be more common in men than in women, but some types of NHL are more common in women
• Race, ethnicity, and geography: more common in Caucasians than African Americans and Asian Americans, and more common in developed countries
• Family history
• Exposure to certain chemicals and drugs, such as benzene, certain herbicides and insecticides, some chemotherapy drugs used to treat other cancers, and certain drugs used to treat rheumatoid arthritis, such as methotrexate and tumor necrosis factor (TNF) inhibitors
• Radiation exposure: radiation therapy treatment for other cancers and survivors of atomic bombs and nuclear reactor accidents
• Weakened immune system
  • Organ transplant recipients treated with immunosuppressants
  • Human immunodeficiency virus (HIV)
  • Some genetic syndromes, such as ataxia-telangiectasia (AT) and Wiskott-Aldrich syndrome
• Autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE or lupus), Sjögren disease, and celiac disease
• Certain infections
• Being overweight or obese
• Breast implants (rare)

Non-Hodgkin lymphoma is diagnosed with a physical exam and tests such as:

• Lymph node biopsy
• Bone marrow aspiration and biopsy 
• Imaging tests
  • X-rays
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Positron emission tomography (PET) scan
  • Ultrasound
• Blood tests
  • Complete blood count (CBC) 
  • Erythrocyte sedimentation rate (ESR) 
  • Tests to check liver and kidney function 
  • Hepatitis B and C virus testing
  • HIV test
• Echocardiogram (an ultrasound of the heart) or a MUGA scan 
• Lumbar puncture (spinal tap)
• Lung (pulmonary) function tests (PFTs) 

Treatments for non-Hodgkin lymphoma may include one or more of the following:

• Chemotherapy, alone or in combination
  • Alkylating agents
    • Cyclophosphamide
    • Chlorambucil
    • Bendamustine
    • Ifosfamide 
• Corticosteroids
  • Prednisone 
  • Dexamethasone
• Platinum drugs
  • Cisplatin
  • Carboplatin
  • Oxaliplatin
• Purine analogs 
  • Fludarabine
  • Pentostatin
  • Cladribine (2-CdA)
• Anti-metabolites 
  • Cytarabine (ara-C)
  • Gemcitabine
  • Methotrexate
  • Pralatrexate
• Anthracyclines
  • Doxorubicin 
  • Liposomal doxorubicin
• Others
  • Vincristine
  • Mitoxantrone
  • Etoposide (VP-16)
  • Bleomycin
• Immunotherapy 
  • Monoclonal antibodies
    • Rituximab (Rituxan)
    • Obinutuzumab (Gazyva)
    • Ofatumumab (Arzerra)
    • Ibritumomab tiuxetan (Zevalin)
• Antibodies that target CD19
  • Tafasitamab (Monjuvi) 
• Antibodies targeting CD52
  • Alemtuzumab (Campath) 
• Antibodies that target CD30
  • Brentuximab vedotin (Adcetris) 
• Antibodies that target CD79b
  • Polatuzumab vedotin (Polivy) 
• Immune checkpoint inhibitors
  • Pembrolizumab (Keytruda) 
• Immunomodulating drugs
  • Thalidomide (Thalomid) 
  • Lenalidomide (Revlimid) 
• Chimeric antigen receptor (CAR) T-cell therapy
  • Axicabtagene ciloleucel (Yescarta, also known as axi-cel) 
  • Tisagenlecleucel (Kymriah, also known as tisa-cel) 
  • Lisocabtagene maraleucel (Breyanzi, also known as liso-cel) 
  • Brexucabtagene autoleucel (Tecartus, also known as brexu-cel) 
• Targeted therapy
  • Proteasome inhibitors
    • Bortezomib (Velcade) 
• Histone deacetylase (HDAC) inhibitors
  • Romidepsin (Istodax) 
  • Belinostat (Beleodaq) 
• BTK inhibitors
  • Ibrutinib (Imbruvica) 
  • Acalabrutinib (Calquence) 
  • Zanubrutinib (Brukinsa) 
• PI3K inhibitors
  • Idelalisib (Zydelig) 
  • Copanlisib (Aliqopa) 
  • Duvelisib (Copiktra) 
  • Umbralisib (Ukoniq) 
• EZH2 inhibitor
  • Tazemetostat (Tazverik) 
• Nuclear export inhibitor
  • Selinexor (Xpovio) 
• Radiation therapy 
• Bone marrow transplant (also called stem cell transplant) 
• Palliative and supportive care
  • Care aimed at helping with problems related to the NHL and its treatment
  • Treatments to prevent infections
  • Treatments for low blood counts
  • Treatment to relieve symptoms such as nausea or pain