Topic Overview
What is non-Hodgkin's lymphoma?
Non-Hodgkin's
lymphoma (NHL) is cancer of the
lymphatic system, which is part of the
immune system. The lymphatic system is found
throughout the body. When you have this disease, cells in the lymphatic system
either grow without control or do not die as cells normally do.
There are many types of NHL. Sometimes they are grouped as:
- Aggressive lymphomas, which are also called
intermediate-grade and high-grade lymphomas. These cancers tend to grow and
spread quickly and cause severe symptoms.
- Nonaggressive lymphomas,
which are also called indolent or low-grade lymphomas. These tend to grow and
spread quite slowly and cause few symptoms.
Non-Hodgkin's lymphoma is different from
Hodgkin's lymphoma.
NHL can start almost
anywhere in the body. It may start in a single
lymph node, a group of lymph nodes, or an organ such
as the
spleen. NHL can spread to almost any part of the body,
including the liver and
bone marrow.
Treatment can cure some
people and may allow others to live for years. How long you live depends on the
type of NHL you have and how early it’s diagnosed.
What causes non-Hodgkin's lymphoma?
The cause of
NHL is not known. The abnormal cell changes may be triggered by an infection or
exposure to something in the environment. It is not contagious.
What are the symptoms?
Symptoms of NHL
include:
- A painless swelling of the lymph nodes in the neck, underarm,
or groin. This is the most common symptom.
- Fever not caused by
another health problem.
- Night sweats.
- Extreme
fatigue.
- Weight loss you can't explain.
- Itchy skin.
- Reddened patches on the skin.
- A cough or shortness of
breath.
- Pain in the belly or back.
How is non-Hodgkin's lymphoma diagnosed?
Your
doctor will do a physical exam and ask you questions about your health. The
exam includes checking the size of your lymph nodes in your neck, underarm, and
groin.
Your doctor will take a piece of body tissue (biopsy) to diagnose NHL. The tissue usually is taken
from a lymph node. Your doctor also may do other test, including tests to see
what kind of NHL you have.
How is it treated?
Your treatment depends on the
type of lymphoma you have, the stage of the disease, your age, and your general
health. You may not need treatment until you have symptoms. The treatment
options are:
- Watchful waiting, which is being under your doctor’s care but not yet getting
treatment.
- Radiation therapy, which is using
high-dose X-rays to kill cancer cells.
- Chemotherapy,
which is using medicine to kill cancer cells.
- Monoclonal antibody therapy, which can boost your
body's natural defenses against disease, slow how fast the cancer grows, and
carry radiation or medicines that kill cancer cells.
- Stem cell transplant plus chemotherapy. A stem cell transplant replaces
damaged bone marrow cells with healthy stem cells.
How do you deal with your emotions?
When you have
cancer, you may feel confused, alone, and scared. Your loved ones may feel this
way too. You are not alone. Others are facing the same struggles, and they know
what you are going through. Many of them are feeling the same way.
To help yourself:
- Get the support you need. Spend time with
people who care about you, and let them help you. Talk to your hospital social
worker if you need help with bills or have other worries. Your local American
Cancer Society also may be helpful.
- Take good care of yourself.
Get plenty of rest, eat healthy meals, and get regular exercise.
- Talk about your feelings, and find a support group. Other people
who have NHL can help you, and your experience can help them.
- Do
everything you can to stay positive. Set a goal each day to do something
special for yourself or someone else.
If your emotions are too much to handle, be sure to tell
your doctor. You may be able to get counseling or other types of help.
Frequently Asked Questions
Learning about non-Hodgkin's lymphoma: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Living with non-Hodgkin's lymphoma: | |
Cause
The cause of
non-Hodgkin's lymphoma (NHL) is unknown. The incidence
of NHL has continued to increase over the years. When a person has
non-Hodgkin's lymphoma, abnormal rapid cell growth occurs. This abnormal growth
may need a "trigger" to start, such as an infection or exposure to something in
your environment. There is also a link between NHL and problems with the immune system. NHL is not contagious and is not caused by injury.1
Symptoms
Symptoms of
non-Hodgkin's lymphoma (NHL) depend on the area of the
body affected by the disease. The most common symptom is a painless swelling of
the
lymph nodes in the neck, underarm, or groin. Other
symptoms may include:
- Unexplained fever.
- Night sweats.
- Extreme
fatigue.
- Unexplained weight loss.
- Itchy
skin.
- Reddened patches on the skin.
- A cough or shortness of
breath.
- Pain in the abdomen or
back.
What Happens
In
non-Hodgkin's lymphoma (NHL), either abnormal cells in
the
lymphatic system divide and grow without order or
control or old cells do not die normally. Lymphatic tissue is present in many
areas of the body, so non-Hodgkin's lymphoma can start almost anywhere in the
body.
Non-Hodgkin's lymphoma may occur in a single
lymph node, a group of lymph nodes, or an organ. And
it can spread to almost any part of the body, including the
liver,
bone marrow, and
spleen. Doctors classify NHL into
stages based on where the lymphoma is growing in the
body.
Over time, lymphoma cells may replace the normal cells in
the bone marrow. Bone marrow failure results in the inability to produce red
blood cells that carry oxygen, white blood cells that fight infection, and
platelets that stop bleeding.
Long-term survival depends on the
type of non-Hodgkin's lymphoma and the stage of the disease when it is
diagnosed. Approximately 80 out of 100 people diagnosed with non-Hodgkin's
lymphoma are alive 1 year after the disease is diagnosed. That number drops to
about 65 out of 100 at 5 years and 54 out of 100 at 10 years.2
What Increases Your Risk
No one knows exactly what
increases your risk of getting
non-Hodgkin's lymphoma (NHL). Experts do agree that
the disease is not caused by injury and is not contagious. The following risk
factors may increase your chances of having the disease. But most people with
these risk factors do not ever have non-Hodgkin's lymphoma. And many people who
have non-Hodgkin's lymphoma do not have any of these risk factors.1
- Being male. NHL is more common in men than
in women.
- Age. The likelihood of getting NHL
increases as you get older.
- Impaired immune system. NHL is most common among those who have an
impaired immune system, an autoimmune disease, or HIV
or AIDS. It also occurs among those who take immunosuppressant medicines, such
as medicines following an organ transplant.
- Viral infection. A
viral infection, such as
Epstein-Barr virus, increases the risk of developing
NHL.
- Bacterial infection. Infection with
Helicobacter pylori increases the risk of lymphoma
involving the stomach.
- Environmental exposure. Exposure to agricultural pesticides or fertilizers, solvents, and other chemicals may increase the
risk of developing NHL.
When To Call a Doctor
Call your doctor to schedule an
appointment if you have had any symptoms for longer than 2 weeks, such
as:
- Painless swelling in the lymph nodes in the
neck, underarm, or groin.
- Unexplained fever.
- Drenching
night sweats.
- Extreme fatigue.
- Unexplained weight loss
in the past 6 months.
- Itchy skin.
- Cough or shortness
of breath.
- Pain in the abdomen or back.
Watchful Waiting
Watchful waiting (surveillance) is a period
after the diagnosis of some types of non-Hodgkin's lymphoma (NHL) when you are not receiving treatment but are still being watched closely by your doctor. Watchful waiting is not appropriate for aggressive or
high-grade lymphoma. Watchful waiting does not mean that your doctor is giving
up or refusing to give you treatment. During this time you will:
- Have regularly scheduled appointments with your
doctor.
- Receive periodic medical tests, including scans and blood
tests.
- Be told which symptoms to report to your doctor
immediately.
Watchful waiting may be as effective as immediate
aggressive treatment for some types of NHL. But watchful waiting ends
when one of the following occurs:
- Symptoms develop.
- Lymphoma tumor
size increases.
- Organs do not function normally.
Who To See
Doctors who can help diagnose
non-Hodgkin's lymphoma (NHL) include:
When NHL is suspected, a tissue sample (biopsy) is needed to make a diagnosis. A biopsy for
non-Hodgkin's lymphoma is usually taken from a lymph node. But other tissues
may be sampled as well. A
surgeon will remove a sample of tissue so that a
pathologist can examine it under a microscope to check
for cancer cells.
Non-Hodgkin's lymphoma is usually treated by a
medical oncologist or a
hematologist. If you require radiation therapy, you
will also see a
radiation oncologist.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
If
non-Hodgkin's lymphoma (NHL) is suspected, your doctor
will ask about your medical history and perform a physical exam. This
exam includes checking for enlarged
lymph nodes in your neck, underarm, and groin.
A tissue sample (biopsy) is needed to make a diagnosis.
A biopsy for non-Hodgkin's lymphoma is usually taken from a
lymph node, but other tissues may be sampled as
well.
A
bone marrow aspiration and biopsy is usually done to find
out if lymphoma cells are present in the bone marrow.
Your doctor
may also order other tests, including:
- Blood tests, such as a
chemistry screen to measure the levels of several
substances in the blood and a
CBC (complete blood count) to provide information
about the kinds and numbers of cells in the blood.
- A
chest X-ray to provide a picture of organs and
structures within the chest, including the heart and lungs, the blood vessels
of the chest, and the thin sheet of muscle (diaphragm) that separates the chest
cavity from the abdominal cavity.
- A
CT scan (computed tomography) or
MRI (magnetic resonance imaging) to provide detailed
pictures of the organs and structures in the chest, abdomen, and pelvis.
- PET scan (positron emission tomography) to show areas
of increased
metabolic activity. Metabolic activity refers to all
of the chemical processes that take place in the body, such as using sugars for
energy. Metabolic activity is generally high in cancer cells.
- Lab tests, such as flow cytometry, that check the types of cells in a biopsy sample. These tests help
your doctor find out the type of lymphoma.
- Lumbar puncture (also called a spinal tap) to find out whether lymphoma cells
are in the fluid (cerebrospinal fluid, or CSF)
surrounding your brain and spinal cord.
- Multigated acquisition
(MUGA) scan, which is a type of
cardiac blood pool scan. A cardiac blood pool scan
shows how well your heart is pumping blood to the rest of your body. A MUGA
scan can show whether your heart is strong enough to tolerate certain types of
chemotherapy, like doxorubicin.
Early Detection
At this time, there are no special tests
recommended for early detection of non-Hodgkin's lymphoma. The best strategy
for early diagnosis is to see your doctor if you develop signs or symptoms of
NHL.
Treatment Overview
Different types of treatment are
used for different types of
non-Hodgkin's lymphoma (NHL). Treatment of NHL depends
on:
- The
stage of the disease.
- The type of lymphoma. The kind of treatment
you have will depend on whether you have B-cell or T-cell lymphoma and whether
it is fast-growing or slow-growing.
- The size of the tumor, where the lymphoma is located, and what organs are
involved.
- Your general health.
- Whether you have had
lymphoma in the past (recurrent disease). Although lymphoma that has come back
(recurred) may be controlled, it often is not curable.
Initial treatment
Treatment recommendations that
may be appropriate when you are first diagnosed with
non-Hodgkin's lymphoma include:
- Watchful waiting (surveillance), a
period of time after the diagnosis of some types of NHL when you are not receiving treatment but are still being watched closely by your doctor. Watchful waiting gives as good or better results than more aggressive treatment
for some types of NHL, such as advanced low-grade indolent lymphoma.
- Radiation therapy,
which is often the treatment of choice for early-stage, indolent NHL. Radiation
therapy may be used alone or combined with other treatment options for more
advanced NHL.
- Chemotherapy, which kills cancer cells or stops them from dividing. The way chemotherapy is given depends on the type and stage of cancer. This may include taking it by mouth or having it injected into a vein or muscle. Or chemotherapy may be placed directly into the spine, an organ, or into the belly.
- Monoclonal antibody therapy. This is a cancer treatment that uses special antibodies that attach to cancer cells and destroy them without harming normal cells. Examples include rituximab (Rituxan) and alemtuzumab (Campath).
If you have recently been diagnosed with non-Hodgkin's
lymphoma, you may experience a lot of emotions. Most people experience
some denial, anger, and grief. Other people may have fewer emotions. There is
no "normal" or "right" way to react to a diagnosis of lymphoma. There are many
steps you can take to help with your emotional reactions. You may find that
talking with family and friends helps you with your emotions. Some people may
find that spending time alone is what they need.
If your reaction
is interfering with your ability to make decisions about your health, it is
important to talk with your doctor. Your cancer treatment center may offer
psychological or financial services. You may also contact your local chapter of
the American Cancer Society to help you find a support group. Talking with
other people who may have had similar feelings can be very helpful.
You may use
home treatment to help you manage the side effects that may happen with NHL
or its treatment.
Ongoing treatment
Schedule regular follow-up
examinations with your doctor after you have been treated for
non-Hodgkin's lymphoma. Follow-up care is an important
part of the overall treatment plan. During regular follow-up care:
- You will probably be seen about every 3 months for the first year and then less often the next year or two. After that, you will only need a checkup each year if you have had no
relapse.
- Changes in health can be discussed with your doctor. To
monitor your health, your doctor may obtain lab tests, such as a
chemistry screen and
CBC, and imaging tests, such as a
chest X-ray or
CT scan.
Report to your doctor any problems you have, as soon as
they appear. If you are having a problem, you may need to make some new
appointments.
Treatment if the condition gets worse
You may be
offered the following treatment options if your disease progresses:
- Radiation therapy may be used alone or in combination with other treatments if
non-Hodgkin's lymphoma (NHL) recurs.
Targeted radiation therapy uses monoclonal antibodies
to deliver radiation directly to lymphoma cells.
- Chemotherapy often effectively treats recurrent NHL.
Sometimes a person may take one type of chemotherapy for several cycles and
later be switched to different medicines if the first medicines are no longer
working.
- Stem cell transplant is often used to treat recurrent lymphoma. Stem cell transplant may
be offered as part of standard treatment or in a clinical trial. Talk with your
doctor to see if a clinical trial may be available for your type of recurrent
disease.
- Biological therapy may be used to treat
recurrent lymphoma.
What to think about
Survival rates have improved
as a result of
clinical trials. Clinical trials provide evidence
about new medicines and treatments that may help people who have non-Hodgkin's
lymphoma live longer and have a better quality of life. If you are interested
in taking part in a clinical trial, check with your doctor to see if there are
any clinical trials available in your area.
Your doctor may use
the term "remission" instead of "cure" when talking about the effectiveness of
your treatment. Although many people with non-Hodgkin's lymphoma are
successfully treated, the term remission is used because cancer can return. It
is important to discuss with your doctor the possibility of recurrence.
Even after effective treatment for NHL, you may be at slightly higher
risk for other types of cancer, especially melanoma, lung, brain, kidney, and
bladder cancers. Be watchful for any symptoms of cancer.
For more
information about specific treatments, see the following topics:
Non-Hodgkin's lymphoma can also occur in children and adolescents, but it is not very common. When children get NHL, it is not the same kind that is common in adults. Also, treatments for children and adolescents are different from treatments for adults.
For more information about treatments for children and adolescents, see the following topics:
Prevention
There is no known way to prevent
non-Hodgkin's lymphoma (NHL). Most people with NHL do
not have known risk factors.
Home Treatment
During treatment for any stage of
non-Hodgkin's lymphoma (NHL), you can use home
treatment to help manage the side effects that may accompany NHL or its
treatment. Home treatment may be all that is needed to manage the following
common problems. If your doctor has given you instructions or medicines to
treat these symptoms, be sure to follow them. In general, healthy habits such
as eating a balanced diet and getting enough sleep and exercise may help
control your symptoms.
- Home treatment for nausea or vomiting
includes watching for and treating early signs of dehydration, such as a dry
mouth, sticky saliva, and reduced urine output with dark yellow urine. Your
doctor also may prescribe
medicines to control nausea and vomiting. For more
information on how to deal with these side effects, see:
Cancer: Controlling Nausea and Vomiting From Chemotherapy.
- Home treatment for diarrhea includes
resting your stomach and being alert for signs of dehydration. Check with your
doctor before you use any nonprescription medicines for your
diarrhea.
- Home treatment for constipation
includes gentle exercise along with adequate intake of fluids and a diet that
is high in fruits, vegetables, and fiber. Check with your doctor before you use a
laxative for your constipation.
- Home treatment for fatigue includes making sure you get extra rest while you are receiving
chemotherapy or radiation therapy. Let your symptoms be your guide. You may be
able to stay in your usual routine and just get some extra sleep. Fatigue is
often worse at the end of treatment or just after treatment is
completed.
- Home treatment for a sore mouth
includes changing your diet, rinsing your mouth with liquid medicines, and
putting a baking soda paste or nonprescription medicine on mouth sores.
Other issues that may arise include:
- Hair loss. This can be emotionally
distressing. Not all chemotherapy medicines cause hair loss, and some people
have only mild thinning that is noticeable only to them. Talk to your doctor
about whether hair loss is an expected side effect with the medicines you will
take.
- Sleep problems. If you find you have trouble sleeping,
having a regular bedtime, getting some exercise during the day, avoiding caffeine late in the day,
and using other tips to relieve sleep problems may help you sleep more easily.
Many people with lymphoma face emotional issues because of
their disease or its treatment.
- The diagnosis of any type of cancer and the
need for treatment can be very stressful. You may be able to
reduce your stress by expressing your feelings to
others. Learning relaxation techniques may also help you reduce your
stress.
- Your feelings about your body may change following a
diagnosis of cancer and the need for treatment. Adapting to your body image
changes may involve talking openly about your concerns with your partner and
discussing your feelings with your doctor. Your doctor may also be able to
refer you to groups that can offer additional support and
information.
- To prevent weight loss and conserve your strength, be sure to
eat well during treatment for cancer.
Not all forms of cancer or cancer treatment cause pain. If
pain occurs, many treatments are available to relieve it. If your doctor has
given you instructions or medicines to treat pain, be sure to follow them. You
may use
home treatment for pain to improve your physical and mental well-being. Be
sure to discuss with your doctor any home treatment you use for pain.
Medications
Your doctor may prescribe medicines that
will affect the growth of
non-Hodgkin's lymphoma and relieve your symptoms.
Treatment depends on:
- The
stage of the disease.
- The type of lymphoma. The kind of treatment
you have will depend on whether you have B-cell or T-cell lymphoma and whether
it is fast-growing or slow-growing.
- The size of the tumor, where the lymphoma is located, and what organs are
involved.
- Your general health.
- Whether you have had
lymphoma in the past (recurrent disease). While lymphoma that has come back
(recurred) may be controlled, it often is not curable.
Medication Choices
Chemotherapy may be used alone or with radiation therapy. Sometimes a
combination of chemotherapy medicines is more effective than a single
drug. The most commonly used combination is called CHOP, which combines
cyclophosphamide,
doxorubicin,
vincristine, and
prednisone.
Your doctor will work with you to find the best medicine for your kind of lymphoma.
For more information about medicine treatments for adults, see the
following topics:
For more information about medicine treatments for children and adolescents, see the
following topics:
What To Think About
Chemotherapy causes many side effects. These side effects
are usually temporary and go away when treatment is stopped. Your doctor may
prescribe
medicines to control nausea and vomiting from
chemotherapy.
Older adults may find side effects harder to tolerate.
Side effects may also cause more problems if you have other diseases, such as
diabetes,
chronic lung disease, or
coronary artery disease.
You may not be able to become
pregnant or father a child after chemotherapy treatment. Discuss fertility
issues with your doctor before starting treatment. Chemotherapy medicines can
also cause birth defects. If you are pregnant or wish to father a child,
discuss the risk of birth defects with your doctor before using any
chemotherapy medicine.
Surgery
Surgery is often used to obtain a biopsy sample when NHL is being diagnosed or classified. But surgery is used only rarely in the treatment of non-Hodgkin's lymphoma.
What to think about
Because of recent
improvements in body scans (such as the
CT scan,
MRI, and
PET scan), exploratory surgery is rarely used to stage
NHL.
Other Treatment
Radiation therapy
is often the treatment of choice for early-stage or nonaggressive (indolent)
non-Hodgkin's lymphoma (NHL). Radiation therapy may be
used alone or combined with other treatment options, such as chemotherapy, for
later or more advanced NHL.
Stem cell transplant may be used to treat NHL that is in remission or has relapsed. Stem cells may be obtained from blood, through a peripheral blood stem cell transplant (PBSCT). Or stem cells can be obtained from bone, in a bone marrow transplant (BMT). PBSCT is the most common method for treating NHL.
There are many other treatments for non-Hodgkin's lymphoma, because there are many kinds of lymphomas. Treatments sometimes include the use of interferon or antibiotic medicines. Your doctor will suggest the treatment that works best for your kind of lymphoma. Or your doctor may suggest that you join a clinical trial. Some treatments being used in clinical trials include lymphoma vaccines and stem cell transplants with high-dose chemotherapy.
Palliative care
If your
non-Hodgkin's lymphoma gets worse, you may want to
think about
palliative care. Palliative care is a kind of care for
people who have illnesses that do not go away and often get worse over time. It
is different from care to cure your illness, called curative treatment.
Palliative care focuses on improving your quality of life—not just in your body
but also in your mind and spirit. Some people combine palliative care with
curative care.
Palliative care may help you manage symptoms or
side effects from treatment. It could also help you cope with your feelings
about living with a long-term illness, make future plans around your medical
care, or help your family better understand your illness and how to support
you.
If you are interested in palliative care, talk to your
doctor. He or she may be able to manage your care or refer you to a doctor who
specializes in this type of care.
For more information, see the
topic
Palliative Care.
End-of-life issues
Non-Hodgkin's lymphoma is often
a progressive condition. If you have been diagnosed with NHL, you may wish to
discuss with your family and your doctor the health care and other legal issues
that arise near the end of life.
A time may come when your goals
or the goals of your loved ones may change from treating or curing an illness
to maintaining comfort and dignity. You may find it helpful and comforting to
state your health care choices in writing (with an
advance directive or living will) while you are still
able to make and communicate these decisions. Think about your treatment
options and which kind of treatment will be best for you. You may wish to
choose a
health care agent to make and carry out decisions
about your care if you become unable to speak for yourself. For more
information, see the topic
Care at the End of Life.
Other Places To Get Help
Organizations
| Leukemia and Lymphoma Society |
| 1311 Mamaroneck Avenue |
| White Plains, NY 10605 |
| Phone: | 1-800-955-4572
(914) 949-5213 |
| Fax: | (914) 949-6691 |
| Web Address: | http://www.leukemia.org |
| |
The Leukemia and Lymphoma Society is the world's largest voluntary
health organization dedicated to funding blood cancer research, education, and
patient services. The Society's mission is to cure leukemia, lymphoma,
Hodgkin's lymphoma, and myeloma and to improve the quality of life for patients
and their families. |
|
| American Cancer Society (ACS) |
| Phone: | 1-800-ACS-2345 (1-800-227-2345) |
| TDD: | 1-866-228-4327 toll-free |
| Web Address: | www.cancer.org |
| |
The American Cancer Society (ACS) conducts educational
programs and offers many services to people with cancer and to their families.
Staff at the toll-free numbers have information about services and activities
in local areas and can provide referrals to local ACS divisions. |
|
| Cancer.Net |
| Phone: | 1-888-651-3038
(571) 483-1300 |
| Fax: | (571) 366-9537 |
| Email: | contactus@cancer.net |
| Web Address: | www.cancer.net |
| |
Cancer.Net is the information website of the American
Society of Clinical Oncology (ASCO) for people living with cancer and for those
who care for them. ASCO is the world's leading professional organization
representing physicians of all oncology subspecialties. Cancer.Net provides
current oncologist-approved information on living with cancer. |
|
| National Cancer Institute (NCI) |
| 6116 Executive Boulevard |
| Suite 300 |
| Bethesda, MD 20892-8322 |
| Phone: | 1-800-4-CANCER (1-800-422-6237) |
| Web Address: | www.cancer.gov (or
https://cissecure.nci.nih.gov/livehelp/welcome.asp# for live help
online) |
| |
The National Cancer Institute (NCI) is a U.S. government
agency that provides up-to-date information about the prevention, detection,
and treatment of cancer. NCI also offers supportive care to people who have cancer
and to their families. NCI information is also available to doctors, nurses,
and other health professionals. NCI provides the latest information about
clinical trials. The Cancer Information Service, a service of NCI, has trained
staff members available to answer questions and send free publications.
Spanish-speaking staff members are also available. |
|
References
Citations
- Friedberg JW, et al. (2008). Non-Hodgkin's lymphomas. In
VT DeVita Jr et al., eds., DeVita, Hellman and Rosenberg's Cancer: Principles and Practice of Oncology, 8th ed., vol. 2, pp. 2098–2143. Philadelphia: Lippincott Williams and
Wilkins.
- American Cancer Society (2009). Cancer Facts and Figures 2009. Available online: http://www.cancer.org/downloads/STT/500809web.pdf.
Other Works Consulted
- American Joint Committee on Cancer (2010). Hodgkin and non-Hodgkin lymphomas section in Lymphoid
neoplasms. AJCC Cancer Staging Manual, 7th ed., pp.
607–611. New York: Springer.
- Bierman PJ, et al. (2008). Non-Hodgkin’s lymphomas. In
L Goldman, D Ausiello, eds., Cecil Medicine,
23rd ed., pp. 1408–1419. Philadelphia: Saunders Elsevier.
- Foon KA, Fisher RI (2006). The non-Hodgkin lymphomas.
In MA Lichtman et al., eds., Williams Hematology, 7th
ed., pp. 1407–1459. New York: McGraw-Hill.
- Kyle F, Hill M (2008). Non-Hodgkin’s lymphoma
(diffuse large B cell lymphoma), search date April 2007. Online version of
BMJ Clinical Evidence. Also available online:
http://www.clinicalevidence.com.
- National Cancer Institute (2009). Adult Non-Hodgkin Lymphoma Treatment (PDQ): Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/healthprofessional.
- National Cancer Institute (2009). Childhood Non-Hodgkin Lymphoma Treatment (PDQ): Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/child-non-hodgkins/healthprofessional.
- National Cancer Institute (2010). Adult Non-Hodgkin Lymphoma PDQ: Treatment – Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/HealthProfessional.
- National Cancer Institute (2010). Adult Non-Hodgkin Lymphoma PDQ: Treatment – Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/patient.
- National Cancer Institute (2010). Childhood Non-Hodgkin Lymphoma PDQ: Treatment – Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/child-non-hodgkins/HealthProfessional.
- National Cancer Institute (2010). Childhood Non-Hodgkin Lymphoma PDQ: Treatment – Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/child-non-hodgkins/patient.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Douglas A. Stewart, MD - Medical Oncology |
|---|
| Last Revised | May 28, 2010 |
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Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.