Non-Hodgkin's Lymphoma

Epidemiology

incidence increases with age

non-Hodgkin's lymphoma typically resents with painless lymphadenopathy

Nodal involvment may not follow orderly anatomic progression.

Histology important in predicting progression and response to treatment

Malignant cell is typically a B lymphocyte, but may be T lymphocyte or NK cell

B cell: precursor

mature

CLL/SLL
marginal zone NHL
mantle cell NHL
follicular lymphoma
- indolent, incurable in most, though possible success with allgenic BMT or very early disease
diffuse large B cell
- aggressive lymphoma, curable with R-CHOP plus anti-CD20
Burkitt's lymphoma

T cell

precursor

mature:

Watch and wait for many folks

oral or IV chemo, radiation

anti-CD20 may be used; can be coupled to radioisotope

Prognostic points include:

5 year survival:

0-1: 73%

2: 51%

3: 43%

4-5: 26%

Natural history:

indolent: years

aggressive: months

leukemia-like: weeks

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