Non-Hodgkin lymphoma

Non-Hodgkin Lymphomas
Classification and external resources
Micrograph of mantle cell lymphoma, a type of non-Hodgkin lymphoma. Terminal ileum. H&E stain.
ICD-10	C82-C85
ICD-9	200, 202
ICD-O:	9591/3
OMIM	605027
DiseasesDB	9065
MedlinePlus	000581
eMedicine	med/1363 ped/1343
MeSH	D008228

The non-Hodgkin lymphomas (NHLs) are a diverse group of blood cancers that include any kind of lymphoma except Hodgkin's lymphomas.^[1] Types of NHL vary significantly in their severity, from indolent to very aggressive.

Lymphomas are types of cancer derived from lymphocytes, a type of white blood cell. Lymphomas are treated by combinations of chemotherapy, monoclonal antibodies, immunotherapy, radiation, and hematopoietic stem cell transplantation.

Non-Hodgkin lymphomas were classified according to the 1982 Working Formulation which recognizes 16 types. The Working Formulation is now considered obsolete, and the classification is commonly used primarily for statistical comparisons with previous decades. The Working Formulation has been superseded twice.

The latest lymphoma classification, the 2008 WHO classification, largely abandoned the "Hodgkin" vs. "Non-Hodgkin" grouping. Instead, it lists over 70 different forms of lymphomas in four broad groups.^[2]

History

Hodgkin lymphoma (H, Hodgkin disease), described by Thomas Hodgkin in 1832, was the first form of lymphoma described and defined. Other forms were later described and there was a need to classify them. Because Hodgkin lymphoma was much more radiation-sensitive than other forms, its diagnosis was important for oncologists and their patients. Thus, research originally focused on it. The first classification of Hodgkin lymphoma was proposed by Robert J. Luke in 1963.

While consensus was rapidly reached on the classification of Hodgkin lymphoma, there remained a large group of very different diseases requiring further classification. The Rappaport classification, proposed by Henry Rappaport in 1956 and 1966, became the first widely accepted classification of lymphomas other than Hodgkin. Following its publication in 1982, the Working Formulation became the standard classification for this group of diseases. It introduced the term non-Hodgkin lymphoma (NHL) and defined three grades of lymphoma.

However, NHL consists of 16 different conditions that have little in common with each other. They are grouped by their aggressiveness. Less aggressive non-Hodgkin lymphomas are compatible with a long survival while more aggressive non-Hodgkin lymphomas can be rapidly fatal without treatment. Without further narrowing, the label is of limited usefulness for patients or doctors.

Modern usage of term

Nevertheless, the Working Formulation and the NHL category continue to be used by many. To this day, lymphoma statistics are compiled as Hodgkin's vs non-Hodgkin lymphomas by major cancer agencies, including the National Cancer Institute in its SEER program, the Canadian Cancer Society and the IARC.

See also

• Lymphoma, for information about all forms of NHL as well as Hodgkin's lymphoma
• Chemotherapy, for information on the standard of care of all forms of non-Hodgkin lymphomas.
• CHOP-R for the most common chemotherapeutic regimen for lymphoma.

References

1. ^ "non-Hodgkin lymphomas " at Dorland's Medical Dictionary
2. ^ ed. by Steven H Swerdlow et al. (2008). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Oxford Univ Pr. ISBN 978-92-8322431-0. 

External links

• Non-Hodgkin Lymphoma at American Cancer Society
• Non-Hodgkins Lymphoma from Cancer.net (American Society of Clinical Oncology)
• Patient information on non-Hodgkin lymphoma
• non-Hodgkin in Brain MR Scans of Primary Brain Lymphoma
• Lymphoma Association – Specialist UK charity providing free information and support to patients, their families, friends and carers