Contact Us Facebook

Non-Hodgkin’s Lymphoma

Non-Hodgkin lymphoma (NHL) is a group of blood cancers that begin in lymphocytes (white blood cells that are part of your immune system). NHLs can be indolent (slow-growing) or aggressive (fast-growing) and arise from B cells, T cells, or (less commonly) NK cells. Your exact subtype and stage guide testing, treatment, and follow-up.  

Understanding the Lymph System 

Lymphomas start in the body’s lymphatic system (lymph nodes, lymph vessels, spleen, thymus, tonsils/adenoids, bone marrow, and other lymph tissues). Because lymph tissue exists throughout the body, NHL can arise in many places and sometimes in organs outside lymph nodes (extranodal sites).  

Common NHL Subtypes 

Diffuse large B-cell lymphoma (DLBCL) 

Follicular lymphoma (FL)  

Marginal zone lymphomas (e.g., MALT) and mantle cell lymphoma (MCL).  

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).  

T-cell lymphomas (e.g., peripheral T-cell lymphoma, anaplastic large cell lymphoma).  

Signs & Symptoms

Symptoms vary by subtype and site, but may include: 

  • Painless, enlarged lymph nodes (neck, armpit, groin)  
  • “B symptoms”: fever, drenching night sweats, unexplained weight loss  
  • Fatigue, decreased appetite, or symptoms from extranodal sites (e.g., abdominal discomfort)  

If symptoms persist or worsen, schedule an evaluation—especially if you have risk factors.  

Risk Factors

Risk varies by subtype. Factors linked with increased risk include older age, male sex, weakened immunity (e.g., HIV, post-transplant), and certain infections (e.g., H. pylori for some MALT lymphomas; HTLV1 for specific T-cell lymphomas; EBV in select settings). Most people with these risks do not develop NHL.  

Diagnosis

NHL diagnosis relies on tissue review and specialized testing: 

of a lymph node or involved tissue to define the exact subtype using pathology, immunophenotyping/flow cytometry, and sometimes molecular tests.  

(often PET/CT) to determine disease extent and identify the best biopsy site. 

and (in selected cases) bone marrow biopsy or lumbar puncture for staging and risk assessment.  

Staging 

NHL in adults is staged using the Lugano classification (a modern update of Ann Arbor). Stages I–IV describe how widely lymphoma has spread, with suffixes such as E (extranodal) and special notes for bulky disease. Accurate staging helps match treatment intensity to your situation.  

Treatment Options

Treatment is individualized based on subtype, stage/bulk, symptoms, molecular features, overall health, and your goals. 

Indolent NHL (e.g., Follicular Lymphoma, Some Marginal Zone Lymphomas) 

  • Active surveillance (“watchful waiting”) when there are no symptoms or organ threats—with regular check-ins and labs.  
  • Localized radiation for select early, confined disease; systemic therapy if/when symptoms or progression occur.  

Aggressive NHL (e.g., DLBCL, High grade B-cell Lymphomas) 

Combination chemoimmunotherapy (e.g., regimens built around an antiCD20 antibody and chemotherapy) is standard for many first-line settings; radiation may be added in specific cases.  

Relapsed/Refractory Disease & Innovative Therapies 

  • Stem cell transplant (autologous or allogeneic) is considered for select patients after relapse.  
  • Cellular immunotherapies (e.g., CD19 CAR T-cell therapy) and bispecific antibodies (CD20×CD3) are important options in several Bcell NHLs, with expanding roles and earlier use in some settings. Your team will discuss benefits, logistics, and potential side effects.  
  • Targeted therapies for specific subtypes or biomarkers may be used alone or with antibodies/chemo, depending on your prior treatments and response.  

Because there are many NHL subtypes and the field evolves quickly, clinical trials are often recommended at various decision points. They can provide access to promising therapies and help answer important questions about sequencing and combinations.

Prognosis

Outlook depends on the exact subtype, stage/bulk, tumor biology, response to therapy, and overall health. Many aggressive NHLs (such as DLBCL) are curable with modern first-line therapy, while most indolent NHLs are highly treatable and often managed over time with excellent disease control. Your physician will explain what your features mean for you.  

Follow-Up & Survivorship  

After treatment (or during active surveillance), follow-up typically includes: 

  • Regular visits, symptom review, and labs; imaging as indicated by subtype and current guidelines.  
  • Vaccinations, infection risk counseling, heart health, and management of late effects of therapy.  
  • Support for return to work/activities, nutrition, exercise, and emotional well-being.  

Why Choose Illinois CancerCare

  • Experienced multidisciplinary team for the full spectrum of B and T-cell NHLs, coordinating diagnostics, therapy, and supportive care—close to home.  
  • Access to clinical trials and referral pathways for advanced cellular therapies when appropriate. (Ask your Illinois CancerCare team about active lymphoma studies.) Current Clinical Trials – Illinois CancerCare

Sources & Patient Friendly References

All information was taken from the NCI (National Cancer Institute) and ACS (American Cancer Society).