Non-Hodgkin Lymphomas

The non-Hodgkin lymphomas (NHL) are a diverse group of neoplasms. Classification is based on morphology, phenotype (e.g., B- vs. T-cell), and ancillary factors that can include clinical presentation, cytogenetics and, sometimes, molecular genetic features. Most patients present with symptoms secondary to nodal growth or bone marrow involvement. The clinical presentation and natural history often varies depending on the subtype of NHL. Radiation alone, and in combination with chemotherapy, has been used successfully in localized disease. Management of extensive stage disease typically involves a systemic chemotherapy approach with combinations of multiple non-cross-resistant agents. In relapsed lymphoma, stem cell transplant has been shown to improve survival in some patients. Monoclonal antibodies and other biologic agents have demonstrated exciting activity and are taking a larger role in newer chemotherapy regimens. Late effects of therapy are a concern; it is hoped that newer targeted and biological therapy approaches may minimize these risks.