prognosis of non Hodgkin's lymphoma

Last edited 05/2019

Prognosis:

  • almost two-thirds (63%) of people diagnosed with Non-Hodgkin lymphoma in England and Wales survive their disease for ten years or more (2010-11)

  • around 7 in 10 (69%) of people diagnosed with Non-Hodgkin lymphoma cancer in England and Wales survive their disease for five years or more (2010-11)

  • 8 in 10 (80%) of people/men/women diagnosed with Non-Hodgkin lymphoma cancer in England and Wales survive their disease for one year or more (2010-11)

  • non-Hodgkin lymphoma survival is similar in men than women

  • non-Hodgkin lymphoma survival in England is highest for people diagnosed aged under 40 (2009-2013)
    • almost 9 in 10 people in England diagnosed with Non-Hodgkin lymphoma aged 15-39 survive their disease for five years or more, compared with more than 4 in 10 people diagnosed aged 80 and over (2009-2013)



  • non-Hodgkin lymphoma survival is improving and has tripled in the last 40 years in the UK. In the 1970s, more than a fifth of people diagnosed with Non-Hodgkin lymphoma cancer survived their disease beyond ten years, now it's almost two-thirds

  • when diagnosed at its earliest stage, 7 in 10 people with Non-Hodgkin lymphoma will survive their disease for five years or more, compared with less than 6 in 10 of people when diagnosed at the latest stage

  • low-grade lymphomas have indolent clinical behavior
    • low grade non-Hodgkin's lymphomas usually have a follicular histology and constitute 30% of the total
    • 90% of patients are over 50 years old
    • symptoms are often non-specific and the disease is usually disseminated at presentation.
    • associated with a comparatively prolonged survival (median survival is 6-10 y)
    • little potential for curative treatment
    • tendency to transform to high-grade lymphomas

  • intermediate and high-grade NHL
    • intermediate grade accounts for 65% of non-Hodgkin's lymphoma
      • incidence is rapidly increasing. Intermediate grade lymphomas occur at all ages, with a median age of 65 years
      • two-thirds arise in lymph nodes, the patient presenting with lymphadenopathy. Other sites include GI tract, skin and brain
      • most common histological type is large cell B cell lymphoma. The tumours are rapidly fatal if not treated
    • high-grade NHL
      • a rare non-Hodgkin's lymphoma found primarily in children and young adults
        • main types are: lymphoblastic lymphoma Burkitt's lymphoma
        • tumour lysis syndrome is a frequent problem during the initiation of chemotherapy.
    • approximately 70% of all patients with intermediate- and high-grade NHL relapse or never respond to initial therapy
    • recurrences are most often within the first 2 years after therapy completion
    • if relapsed or resistant NHL then prognosis is very poor (< 5-10% are alive at 2 years with conventional salvage chemotherapy regimens)
  • if congenital or acquired immunodeficiency then there is an increased risk of lymphoma - these patients respond poorly to therapy
  • aggressive T- or NK-cell lymphomas, in general, have worse prognoses than those with B-cell lymphomas
    • with the exception the Ki-1 anaplastic large T- or null-cell lymphomas
  • low levels of vitamin D have been associated with a decrease in clinical end points (event-free survival and overall survival) in subsets of patients with aggressive B-cell lymphoma

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