Adult Non-Hodgkin Lymphoma and what you should know about itNHL comprises of a group of heterogeneous lymphoproliferative malignancies that have different behavior patterns and treatment responses. NHL usually originates from lymphoid tissues just like Hodgkin lymphoma and is capable of spreading to other organs. However, NHL isn’t as predictable as Hodgkin lymphoma and its predilection is greater when it comes to disseminating to the extra nodal sites. Prognosis of NHL depends on type of histologic, stage of the disease and treatment.

Subtypes of adult NHL

Today, there is a better understanding of NHL and this also comes about with highly sophisticated diagnosis of the condition as well by use of some genetic and immunologic techniques. In addition, there has also been change to the treatment of various pathologic subtypes of this condition as well. The modification by WHO has now led to three major categories being recognized and this depends on the cell lineage and morphology, i.e. Hodgkin lymphoma, B- cell neoplasms and natural kicker/ T- Cells.

Follicular lymphoma

About 20 percent of NHL cases are usually follicular lymphoma and 70 percent are usually indolent lymphomas as reported in European and American clinical trials. The majority of patients suffering from follicular lymphoma are usually aged 50 years and above and at diagnosis, the disease is usually wide spread already. In most cases, nodal involvement is usually accompanied by bone marrow and splenic diseases. In over 90 percent of the patients having follicular lymphoma, 90% of them have bcl-2 gene rearrangement. A couple of factors determine the survival rate of these patients and can be as many as 10 years for some.

Patients diagnosed with lymphoma might experience a relapse with more aggressive histology. Where the clinical relapse pattern shows that disease is actually behaving aggressively, it is important that a biopsy is performed. There are times when it is even important that the therapy being used is changed particularly when a histologic conversion is indicated. Lymphoplasmacytic lymphoma is the same to that of low grade lymphomas but where the viscosity relative is actually greater than four to that of water, it is possible for the patient to manifest signs of hyper viscosity.

Treatment options available for NHL

According to health experts, most cases of NHL are usually aggressive and delaying of therapy until the delivery has appeared may result in some very poor outcomes. There are some investigators who recommend immediate therapy even when the woman is pregnant. The follow ups for treatment usually range anywhere between few months and 11 years. This exposes the children to high dosage of doxorubicin- containing chemotherapy in utero. In most cases for chemotherapeutic agents for NHL treatment, no data exists as far as the long term effects of the chemo on children are concerned. In some cases, pregnancy termination could be an option too.