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Blood Cancer

Diagnosis & Treatment

Non-Hodgkin's Lymphoma

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How is Non-Hodgkin's Lymphoma Diagnosed?

Diagnosis

Since there are many different types of non-Hodgkin's lymphoma, various tests are used to determine if cancer cells exist and, if so, which type. Some methods used for non-Hodgkin's lymphoma diagnosis include:

  • Physical examination checks for possible swollen lymph nodes in the neck, underarm, groin, spleen, or liver
  • Blood and urine tests help rule out the presence of an infection or other disease
  • Imaging tests to look for signs of lymphoma cells in the body, such as:
    • X-Rays provide detailed pictures of internal tissue, bones, and organs
    • CT Scans provide a multidimensional look at your body tissues and structure
    • MRI (Magnetic Resonance Imaging) to show clear and detailed pictures of structures within the body without the use of radiation
    • Positron emission tomography (PET) reveals the metabolic or biochemical function of the tissue and organs
    • Ultrasound (sonography) to produce pictures of the inside of the body using high-frequency sound waves that bounce off tissues and organs in real-time
  • Lymph node biopsy to analyze lymph node tissue
  • Bone marrow biopsy and aspiration procedure to analyze the bone marrow
  • Lumbar puncture (spinal tap) to analyze the spinal fluid

Lymphoma expert Dr. John P. Leonard discusses how treatment for the disease is advancing rapidly.

How is Non-Hodgkin's Lymphoma Treated?

Treatments

At NewYork-Presbyterian, we treat the whole person. Our lymphoma specialists begin by identifying your exact type of non-Hodgkin’s lymphoma and customizing a treatment plan. With more than 70 distinct types of non-Hodgkin's lymphoma and many different types of treatment, our specialists take the time to help you understand your treatment options so you can make an informed decision about what is best for you.

Lymphoma expert Dr. John P. Leonard discusses how treatment for the disease is advancing rapidly.

Medications, targeted therapy, and other treatments

New drugs for non-Hodgkin’s lymphoma have benefited those with the disease in the past several years. This benefit is especially true for therapies that target the unique biological features of lymphoma and zero in on the specific molecules involved in cancer growth.

Our cancer specialists have access to the latest novel treatments and choose those best suited for you and your particular type of lymphoma and are devising new, more effective therapies to extend survival, including:

Targeted drug therapies

  • Histone deacetylase (HDAC) inhibitors can affect which genes are active by interacting with proteins in the chromosomes (histones)
  • BTK (Bruton's tyrosine kinase) inhibitors target the BTK protein as that protein helps some lymphoma cells (B cells) grow and survive
  • PI3K (Phosphatidylinositol e-kinases) inhibitors target the PI3K protein, which sends cellular signals that affect cell growth
  • EZH2 inhibitors work by targeting the EZH2 protein that helps some cancer cells grow
  • Nuclear export inhibitors block the XPO1 protein so that the large B-cell lymphoma (DCBCL) cell cannot move proteins outside its nucleus, causing the lymphoma cells to die
  • Immunomodulatory drugs or cell mods: target cereblon to modulate the tumor microenvironment (cells around the lymphoma) to help fight the lymphoma
  • DNA methyltransferase inhibitors work to change how chromosomes or DNA are read without changing the DNA itself
  • Immunomodulating drugs such as thalidomide (Thalomid) and lenalidomide (Revlimid) can be used to help parts of the immune system

Immunotherapies

Our lymphoma specialists are leveraging developments in biology and experimental therapies to create novel initial chemotherapy-free treatments, aiming to improve patients' outcomes early in the game.

  • Monoclonal antibodies are man-made proteins designed to help your immune system fight infections
  • Chimeric antigen receptor (CAR) T-cell therapy is a treatment where the T-cells are removed from the blood, altered to have specific receptors that attach to proteins on the surface of lymphoma cells and replaced in the patient's blood. These altered cells them seek out the lymphoma cells and launch an attack against them.
  • Antibody-drug-conjugate combines man-made proteins targeted to bind to lymphoma with chemotherapy to kill the cancer
  • Immune checkpoint blockade blocks a signal that tells your immune system to ignore lymphoma. In doing this, it allows your immune system to fight the disease.

Other non-surgical treatments

  • Chemotherapy is often combined with other treatments such as immunotherapy or radiation
  • Precise radiation therapy including image-guided radiation therapy (IGRT) and intensity-modulated radiation therapy (IMRT). Using IGRT and IMRT, our specialists can kill more cancer cells while damaging fewer healthy cells which could mean fewer side effects.
  • Stem cell transplantation (also known as a bone marrow transplant) using the patient's own stem cells or the cells from a donor

Surgical treatment

Our cancer specialists rarely use surgery to treat non-Hodgkin's lymphoma but may be used for lymphomas that start in certain organs outside the lymph system, such as the thyroid or stomach.

FAQs

FAQs

It is important to remember that there are more than 85 different lymphoma subtypes. Different subtypes have vastly different survival rates, and it is important to understand the biology to determine predicted survival accurately.

The long-term outlook for patients with non-Hodgkin's lymphoma depends on the type and stage of the cancer upon diagnosis and the treatment received. Other factors include age, gene changes and proteins found in the cancer cells, and overall health.

Hodgkin's lymphoma was discovered by Dr. Thomas Hodgkin (1798–1866). Dr. Hodgkin was one of the most prominent British pathologists of his time. He was born into a Quaker family, studied medicine in Edinburgh and Paris, and held the position of the conservator of the pathology museum from 1825 until his death at Guy's Hospital Medical School, where he studied preserved specimens of human organs.

Non-Hodgkin’s lymphoma (NHL) is divided into more than 70 types and classified based on the type of lymphocyte, either B lymphocytes (B cells) or T lymphocytes (T cells). Non-Hodgkin’s lymphoma is further classified by other factors, including whether it is aggressive (fast-growing) or indolent (slow-growing).

Get Care

Trust NewYork-Presbyterian for Non-Hodgkin's Lymphoma Treatment

Research shows that the best and most effective treatment starts with an early diagnosis. If you are experiencing symptoms or have a family history of lymphoma or other types of blood cancer, contact a NewYork-Presbyterian specialist near you.