Non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma (NHL) is a collective term for about 50 different lymphomas, of which follicular lymphoma (20-30%) and diffuse large B-cell lymphoma (40%) are the most common. Although NHL forms the largest group of haematological malignancies, it is relatively rare. The disease is systemic in most patients, affecting multiple lymph nodes and often organs. For this reason, systemic treatment is nearly always indicated. NHL often manifests as painless swelling of the lymph nodes, sometimes accompanied by so-called B symptoms, general symptoms such as persistent unexplained fever, severe night sweats, and unexplained weight loss. Follicular lymphoma is often indolent, whereas diffuse large B-cell lymphoma starts as a rapidly progressive lymphadenopathy and often occurs in extranodal sites. Treatment of follicular lymphoma ranges from watchful waiting to combinations of radiotherapy, immunotherapy, and chemotherapy of different intensity. Autologous stem cell transplantation offers the only possibility of cure. The standard treatment for diffuse large B-cell lymphoma is chemotherapy plus treatment with the monoclonal antibody rituximab (R-CHOP). Cure is achieved in more than 50% of patients. © 2013 Bohn, Stafleu van Loghum. Literatuur:.