Non-Hodgkin lymphoma

The non-Hodgkin lymphomas are a diverse group of hematologic cancers which encompass any lymphoma other than Hodgkin lymphoma. Lymphoma is a type of cancer derived from lymphocytes, a type of white blood cell. Many subtypes of non-Hodgkin lymphoma have been described; these are generally grouped by their aggressiveness. Less aggressive non-Hodgkin lymphomas may be chronic diseases which exist for many years, while more aggressive non-Hodgkin lymphomas can be rapidly fatal without treatment. Non-Hodgkin lymphomas are treated by combinations of chemotherapy, monoclonal antibodies, immunotherapy, radiation, and hematopoietic stem cell transplantation.

History

Hodgkin's Lymphoma (HL, Hodgkin's disease), described by Thomas Hodgkin in 1832, was the first form of lymphoma described and defined. Other forms were later described and there was a need to classify them. Because Hodgkin's lymphoma was much more radiation-sensitive than other forms, its diagnosis was important for oncologists and their patients. Thus, research originally focused on it. The first classification of Hodgkin's Lymphoma was proposed by Robert J. Lukes in 1963.

While consensus was rapidly reached on the classification of Hodgkin's lymphoma, there remained a large group of very different diseases requiring further classification. The Rappaport classification, proposed by Henry Rappaport in 1956 and 1966, became the first widely accepted classification of lymphomas other than Hodgkin's. Following its publication in 1982, the Working Formulation became the standard classification for this group of diseases. It introduced the term Non-Hodgkin's Lymphoma (NHL) and defined three grades of lymphoma.

However, NHL consists of 16 different conditions that have little in common with each other. Without further narrowing, the label is of limited usefulness for patients or doctors. The most recent lymphoma classifications, the 1994 Revised European-American Lymphoma (REAL) classification and the 2001 WHO classification, abandoned the HL vs. NHL grouping. Instead, 43 different forms of lymphoma are listed and discussed separately.

Modern usage of term

Nevertheless, the Working formulation and the NHL category continue to be used by many. To this day, lymphoma statistics are compiled as Hodgkin's vs Non-Hodgkin's lymphoma by major cancer agencies, including the National Cancer Institute in its SEER program, the Canadian Cancer Society and the IARC.