Know The Facts

What Is Lymphoma?1

Lymphoma is the name for a group of blood cancers that develop in the lymphatic system. The two main types are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL).


In 2013, about 731,277 people are living with lymphoma or are in remission (no sign of the disease). This number includes about 172,937 people with Hodgkin lymphoma and 558,340 people with NHL.


Hodgkin lymphoma has characteristics that distinguish it from other diseases classified as lymphoma, including the presence of Reed-Sternberg cells. These are large, cancerous cells found in Hodgkin lymphoma tissues, named for the scientists who first identified them. Hodgkin lymphoma is one of the most curable forms of cancer.


NHL represents a diverse group of diseases distinguished by the characteristics of the cancer cells associated with each disease type. Most people with NHL have a B-cell type of NHL (about 85 percent). The others have a T-cell type or an NK-cell type of lymphoma. Some patients with fast-growing NHL can be cured. For patients with slow-growing NHL, treatment may keep the disease in check for many years.

From the American Cancer Society:

Special concerns when cancer arises in Adolescents and Young Adults (AYA): Cancers occurring in adolescents (ages 15 to 19 years) and young adults (ages 20 to 39 years) are associated with a unique set of issues. Many childhood cancer types are rarely diagnosed after the age of 15, while others, such as Ewing sarcoma and osteosarcoma, are most common during adolescence. Young adults diagnosed with cancer usually receive care from health care providers with adult-focused practices even if these young adults have cancers that are more common in children. However, outcomes are often more successful when treatment is managed by a children’s cancer center.


Studies find that improvements in survival among adolescents and young adults have dramatically lagged behind those in children and even behind those for older adult patients, yet the current 5-year overall relative survival rate is the same as that for children. There is relatively little specific information on survivorship concerns in this age group; however, adolescents and their families have unique stresses and concerns related to cancer, and they could benefit from the coordinated care and psychosocial support provided in specialized pediatric cancer centers.


At the age of 18 and beyond, childhood cancer survivors and newly diagnosed AYA cancer patients often face additional challenges related to insurance coverage. Medicaid covers cancer treatment for pediatric cancer patients who meet income criteria, but the more generous coverage by Medicaid for children lapses at age 18 or 21, depending on the state. Young adults diagnosed with cancer also face unique challenges of coping.

Leukemias and Lymphomas

Leukemia is a cancer of the bone marrow and blood. Almost 90% of cases can be classified into one of four main groups according to cell type and rate of growth: acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML). It is estimated that as of January 1, 2012, there were 298,170 leukemia survivors living in the US, and an additional 47,150 people will be diagnosed with leukemia in 2012.


Almost 90% of leukemia patients are diagnosed at age 20 and older; AML and CLL are the most common types of leukemia in adults. Among children and teens, ALL is most common, accounting for three-fourths of leukemia cases. The median age at diagnosis for ALL is 13 years; the median ages at diagnosis for CLL, AML, and CML are 72, 67, and 65, respectively (Figure 2, page 4).


Lymphomas are cancers that begin in cells of the immune system. There are two basic categories of lymphomas: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), which includes a large, diverse group of cancers. It is estimated that as of January 1, 2012, there were 188,590 HL survivors and 534,950 NHL survivors, and that 9,060 and 70,130 new cases, respectively, will be diagnosed in 2012.

Treatment and survival:

HL. Hodgkin lymphoma is a cancer of the lymph nodes that often starts in the chest, neck, or abdomen. It occurs in all age groups, but is most common in early adulthood (61% of cases are diagnosed between ages 15 and 49, Figure 2, page 4). There are two major types of HL: classic, which is the most common and is distinguishable by the presence of Reed Sternberg cells, and nodular lymphocyte predominant, which is rare and tends to be more slow growing than classic HL.


Treatment varies slightly by type. Classical Hodgkin disease is generally treated with multi-agent chemotherapy often along with radiation therapy. Stem cell transplant may also be recommended for some patients. Brentuximab vedotin (Adcetris) was recently approved to treat HL in certain patients who failed to respond to previous therapies.


For those diagnosed with nodular lymphocyte predominant HL, radiation alone may be appropriate for patients with early stage disease. For those with later-stage disease, chemotherapy plus radiation, as well as the monoclonal antibody rituximab (Rituxan), may be recommended.


Survival rates have improved substantially since the early 1970s. During the most recent time period, the
1-year relative survival rate for all patients diagnosed with Hodgkin disease was 92%; the 5- and 10-year rates were 84% and 79%, respectively.


NHL. The most common types of NHL are diffuse large B-cell lymphoma, representing about one-third of NHL cases, and follicular lymphoma, which represents about one-fifth of NHL cases. Diffuse large B-cell lymphomas grow quickly, yet about half of all patients are cured with treatment. It can affect any age group, but occurs most often in adults ages 50 and older. In con-trast, follicular lymphomas tend to grow slowly and often do not require treatment until the lymphoma causes symptoms. Although standard treatment will not usually cure this cancer, patients may still live a long time. The overall 5-year relative survival rate is 67%.7 Over time, some follicular lymphomas change into the fast-growing diffuse B-cell type. NHL is usually treated with chemotherapy either in combina¬tion with radiation (11%) or without radiation (56%); radiation without chemotherapy (7%) is used less often (Figure 9). Tar¬geted therapies such as rituximab (Rituxan), alemtuzumab (Campath), and ofatumumab (Arzerra) are also used for some types of NHL.


Special concerns of leukemia and lymphoma survivors: Treatments for leukemia and lymphoma can result in a number of significant late effects. Some children with ALL may receive cranial radiation therapy to treat any spread of leukemia to the central nervous system (CNS), which can cause long-term cognitive deficits. Young women treated in childhood with radiation to the chest for Hodgkin lymphoma are at increased risk for developing breast cancer. This type of radiation is also associated with increased risk of various heart complications (e.g., valvular heart disease and coronary artery disease), which can occur decades after treatment is received.


Several forms of leukemia and lymphoma in adults involve long periods of slow progression or remission with the likelihood of eventual accelerated disease or recurrence. While most welcome this period of relatively healthy survivorship, it may pose unique challenges to patients and their loved ones due to anxiety about eventual outcomes.


1 "Lymphoma." The Leukemia & Lymphoma Society®. N.p., n.d. Web. 11 Mar. 2014.


2American Cancer Society. Cancer Treatment and Survivorship Facts & Figures 2012-2013. Atlanta: American Cancer Society; 2012.

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