There are more than 30 lymphomas included in Non-Hodgkins Lymphoma that differ in several ways. There are two distinct groupings of lymphomas based on the speed of growth. Indolent or low-grade lymphomas grow slowly and usually don't require immediate treatment, but eventually may progress into an aggressive lymphoma, which grow quickly. Lymphomas are also classified based on the type of lymphocyte that is affected. These types are called either B-cells or T-cells and approximately 85% of lymphomas are of the B-cell type.
Common Types of Non-Hodgkins Lymphoma
- Diffuse Large B cell Lymphoma – an aggressive type of B-cell lymphoma; 30-35% of people with Non-Hodgkins Lymphoma have this type
- Follicular lymphoma – This type of B-cell lymphoma affects approximately 20% of people with Non-Hodgkins Lymphoma and it usually occurs in people over the age of 60; it is slow-growing and usually starts in the lymph nodes but spreads to the blood, bone marrow and organs
- Mantle cell lymphoma – an aggressive B-cell lymphoma that is often already spread throughout the body when diagnosed; approximately 6% of patients with Non-Hodgkins Lymphoma have this type
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Determining the Stage of Non-Hodgkins Lymphoma
There are four general stages classified when a patient is diagnosed with Non-Hodgkins Lymphoma. The stage tells the doctor and patient how much cancer is in the body and is based on the amount of organs or lymph nodes that are cancerous and whether or not the cancer is widespread. Stage I and II are considered early-stage disease, while stage III and IV are late-stage and also more common because symptoms may not be noticed until the cancer has grown significantly in the patient's body.
Determining a Patient's Risk Score
A risk score will be assessed for patients based on several criteria. The risk score is a prediction of a patient's survival rate and also signifies if the cancer will return after treatment. It makes treatment planning easier because treatment can be tailored to how severe the cancer has become and different options may be available to patients with a low risk score, meaning that their odds of disease returning after treatment are low. For a patient with a high risk score, more aggressive treatment may need to be sought. The risk score is assessed based on:
- Age of patient
- Stage of cancer
- Patient's ability to do everyday tasks
- Number of areas or organs showing disease (not including lymph nodes)
- Level of an enzyme, LDH (lactate dehydrogenase) in the blood: high levels may mean more rapidly growing tumors
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