Non-Hodgkin's lymphoma represents a diverse group of cancers with the distinctions between types based on the characteristics of the cancerous cells. The groups are often classified as indolent or aggressive, or low, intermediate and high grade. Non-Hodgkin's lymphoma is really a group of diseases and not just one type. Each histologic grouping is diagnosed and treated differently, and each has prognostic factors that categorize it as more or less favorable.

New Cases About 63,600 Americans will be diagnosed with lymphoma in 2001 (7,400 cases of Hodgkin's lymphoma and 56,200 cases of non-Hodgkin's lymphoma). The incidence of Hodgkin's lymphoma is consistently lower than that of non-Hodgkin's lymphoma and has decreased over the past 30 years.

Non-Hodgkin's lymphoma is the fifth most common cancer in the United States. The age-adjusted incidence of non-Hodgkin's lymphoma rose by 80 percent from 1973 to 1997; an annual percentage increase of nearly 3 percent.

Age-specific incidence rates are 1.5/100,000 at age 20 for males, and 0.5/100,000 for females. By age 60 they are about even with 22/100,000 population.

Fifty-eight percent of the blood-related cancers are lymphomas.

Incidence by Gender Incidence rates for non-Hodgkin's lymphoma are higher among males than among females. Among the 63,600 new cases of lymphoma in 2001, 56,200 cases will be non-Hodgkin's lymphoma (31,100 males and 25,100 females).

Incidence by Race and Ethnicity Incidence rates are higher in Americans of European descent than among those of African descent. Among women, white Hispanics have the second highest incidence rates.

Incidence by Age Group In every ethnic group incidence rates of non-Hodgkin's lymphoma increase with age. The amount of the increase by age depends on the ethnicity in combination with age. From the age range 30 to mid-50's until age 70 and older the incidence of non-Hodgkin's lymphoma increases five-fold among white non-Hispanic men, but eleven-fold among Filipino men. The comparable rate increases for women are eight-fold and sixteen-fold.

Children In the United States about 1700 children under the age of 20 are diagnosed with lymphoma each year. 750 to 800 cases are non-Hodgkin's lymphoma. Among very young children a diagnosis of non-Hodgkin's lymphoma is more prevalent, whereas adolescents are more commonly diagnosed with Hodgkin's lymphoma.

Burkitts and Burkitts-like tumors predominate among children 5 to 14 years old. Among children 15 to 19 years old, diffuse large cell lymphoma occurs more frequently. The incidence is 10 per million population. It is higher in males than females and higher among children of African descent than children of European descent.

Adults The incidence of lymphomas increases with age. About four cases per 100,000 people occur in 20-year old individuals. The rate increases ten-fold to 40 cases per 100,000 by age 60 and over twenty-fold to 80 cases per 100,000 persons after age 75.

Signs & Symptoms The most common early sign of non-Hodgkin's lymphoma is a painless swelling of a lymph node or nodes, usually in the neck, armpit, groin or abdomen.

Other symptoms may include: fever, night sweats, excessive tiredness, indigestion and abdominal pain, loss of appetite, weight loss or bone pain.

Possible Causes Most cases of lymphoma have no known cause. The bacterium, helicobacter pylori, is associated with the development of lymphoma in the stomach wall. Patients with human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. Burkitt's lymphoma in Africa is associated with prior infection with the Epstein-Barr virus. The virus may play a role in the development of some lymphomas as well. Rural lifestyle and the occupation of farming have been associated with an increased risk of lymphoma. Exposure to certain chemicals contained in herbicides and pesticides in such settings are suspected of playing a role but these specific relationships are still under study.

Treatment Early stage, localized non-Hodgkin's lymphoma may be treated with radiation; widespread disease requires chemotherapy or chemotherapy with radiation, depending on the tumor size, cell type, and location of the lymphoma. Appropriate therapy may result in very extended remissions or cures for many lymphoma patients.

Survival The five-year relative survival rate for non-Hodgkin's lymphoma patients has risen from 31 percent in 1960 to 52 percent in 2001.

Approximately 300,000 members of the population in the United States are living with non-Hodgkin's lymphoma.

Survival for Children In children, five-year relative survival for non-Hodgkin's lymphoma is now 78 percent. This represents a significant improvement in the rate of recovery; even in the 1970s, the majority of children with lymphoma did not live five years after diagnosis.

• Non-Hodgkin's lymphoma survival increased from 56 percent in the time period 1975-1984 to 72 percent in the time period 1985-1994.
• Lymphomas (Hodgkin's and non-Hodgkin's lymphoma) are the third most common cancer in children following leukemia and malignant brain tumors.
• Lymphomas account for 10 percent of the malignancies among children younger than 15 years of age, and 15 percent of malignancies among persons younger than 20 years of age.

Approximately 13,800 males and 12,500 females are expected to die from lymphoma this year.

How to Get More Information
Further details of treatment and supportive care and the beneficial and adverse effects of treatment may be obtained from the Society's free informational booklets on:

The Lymphomas: Hodgkin's Disease/Non-Hodgkin's Lymphoma

Blood and Marrow Stem Cell Transplantation: Leukemia/Lymphoma/Myeloma

Understanding Chemotherapy

For more information contact us, The Leukemia & Lymphoma Society SM, Home Office, 1311 Mamaroneck Avenue, White Plains, N.Y. 10605 or call the Information Resource Center at 1-800-955-4572.

This information was provided by The Leukemia & Lymphoma Society SM.