Non-Hodgkin lymphoma (NHL) affects white blood cells in the lymph system. Although it is a serious condition, most people survive at least 5 years after receiving an NHL diagnosis.

NHL starts in the white blood cells, which are part of the immune system. However, it can spread to other areas and lead to a worse outlook.

Early detection and treatment are important factors that can increase the likelihood of surviving for long periods after an NHL diagnosis.

Keep reading to learn more about the survival rates and outlook for people with NHL.

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According to the American Cancer Society, NHL accounts for 4% of all cancer cases in the United States. It is estimated that it will cause around 20,720 deaths in 2021.

Doctors commonly measure the survival rate of cancer over 5 years. The 5-year survival rate refers to the percentage of people who survive for at least 5 years after a cancer diagnosis.

The average survival rate for NHL will depend on its staging and whether it has spread. NHL can be:

  • Localized: NHL is localized when it only affects one lymph node, one organ in the lymphatic system, or one organ outside the lymphatic system.
  • Regional: Regional NHL is when the cancer has spread from one lymph node to a nearby organ or affects two lymph nodes.
  • Distant: The distant stage of NHL is when the cancer has spread to farther away organs, such as the liver.

There are two main types of NHL: B-cell lymphoma and T-cell lymphoma. B-cell lymphomas make up around 85% of all cases of NHL.

The 5-year survival rate for diffuse large B-cell NHL is 73% for localized and regional cases, and 64% for distant cases. Diffuse large B-cell is an aggressive form of cancer that accounts for most NHL cases in the U.S.

Follicular NHL is another common form of NHL that is less aggressive than diffuse large B-cell NHL. The 5-year survival rates for follicular NHL are:

  • 96% for localized cases
  • 90% for regional cases
  • 85% for distant cases

Another way of classifying the severity of NHL is to use stages. The stages range from stage 1 (least severe) to stage 4 (most severe). According to the National Cancer Institute, the 5-year survival rates by stage are:

  • stage 1: 84%
  • stage 2: 77%
  • stage 3: 71%
  • stage 4: 64%

Doctors also use the International Prognostic Index to estimate the prognosis, or outlook, for different types of NHL. The index includes information on five risk factors. The factors that predict a less promising outlook include:

  • being over age 60
  • having stage 3 or 4 cancer
  • having lymphoma in one or more organs outside the lymph nodes
  • needing assistance to complete daily activities
  • having high levels of lactate dehydrogenase in the blood

There is a second index for follicular NHL, which has different risk factors, such as high blood hemoglobin levels.

While NHL is more common in young people than many other cancers, age is still a primary determinant of a less promising outlook. According to the National Cancer Institute, the percentage of people who die from NHL per age group are:

  • under 20: 0.3%
  • 20­–34: 1%
  • 35­–44: 2%
  • 45­–54: 5%
  • 55­–64: 14%
  • 65­–74: 25%
  • 75­–84: 31%
  • over 84: 23%

It is worth noting that these statistics do not account for variations in the other risk factors mentioned above, such as the stage of the cancer or the presence of other health conditions.

There are many possible treatment options for people with NHL. The best choice of treatment will depend on several factors, such as the:

  • severity of the NHL
  • person’s age
  • subtype of NHL

People with NHL can determine the best treatment options by discussing the risks and benefits with a doctor.

Treatment options might include:

  • Chemotherapy: Chemotherapy involves taking drugs that attack the cancer cells. The treatment also affects healthy cells, which causes side effects.
  • Immunotherapy: Immunotherapy manipulates the body’s immune system to improve its response to cancerous cells.
  • Targeted therapy: These drugs target specific parts of cancer cells, such as genetic components, to slow or stop their growth.
  • Radiation therapy: This uses high-intensity radiation to kill cancer cells.
  • Surgery: Some people can receive surgery to remove tumors.

There are also several newer treatments for NHL that researchers are currently testing in clinical trials, such as stem cell transplants.

Some treatments can cause side effects that typically go away after treatment finishes. They can also cause side effects that begin after treatment and last for months or years, such as:

  • heart problems
  • infertility
  • reduced bone density
  • nerve damage
  • a secondary cancer

After diagnosing NHL, a doctor will determine its stage. The stage refers to how far the cancer has spread, which helps doctors decide how best to treat it.

The Lugano classification system for NHL runs from one to four:

  • Stage 1: This is when the cancer only affects one lymph node area or organ, or only affects one area outside the lymphatic system.
  • Stage 2: The cancer affects two or more lymph nodes and may affect one area outside the lymphatic system.
  • Stage 3: The cancer affects both sides of the lymph nodes or the lymph nodes above the diaphragm and in the spleen.
  • Stage 4: The cancer has spread to at least one organ outside the lymphatic system.

NHL is a serious condition but commonly has a relatively promising outlook. Most people with NHL survive at least 5 years after a diagnosis. However, older people are more likely to die from the condition. Other factors that affect the outlook include the stage and spread of the cancer.

There are many treatment options for NHL, including chemotherapy and immunotherapies. The best treatment approach will depend on various factors, including the NHL stage.