Hodgkins lymphoma survival rate

ON THIS PAGE: You will find information about the number of people who are diagnosed with Hodgkin lymphoma each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors. Use the menu to see other pages.

This year, an estimated 8,110 people (4,570 men and 3,540 women) in the United States will be diagnosed with Hodgkin lymphoma.

It is estimated that 1,000 deaths (590 men and 410 women) from this disease will occur this year. The survival rate has been going up since around 1975 thanks to treatment improvements. From 2007 to 2016, the death rate dropped 4% annually.

Hodgkin lymphoma affects both children and adults. It is most common in 2 age groups. The first group is people ages 15 to 40, particularly young adults in their 20s. The second is people older than 55. The average age of diagnosis is 39. Although the disease is rare in children younger than 5, it is the most commonly diagnosed cancer in teens ages 15 to 19.

The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. These rates may be affected by the subtype and stage of Hodgkin lymphoma and the age and gender of the patient.

The 5-year survival rate for all people with Hodgkin lymphoma is 87%. The 5-year survival rate for stage I is 92%. The 5-year survival rate for stage II Hodgkin lymphoma is 93%. Approximately 40% of people are diagnosed with this stage. For stage III, the 5-year survival rate is 83% and for stage IV, it is almost 73%.

It is important to remember that statistics on the survival rates for people with Hodgkin lymphoma are an estimate. The estimate comes from annual data based on the number of people with this cancer in the United States. Also, experts measure the survival statistics every 5 years. So the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society’s (ACS) publication, Cancer Facts & Figures 2019, the ACS website, and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database (January 2019).

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by Hodgkin lymphoma. Use the menu to choose a different section to read in this guide.

Hodgkin lymphoma 

Hodgkin lymphoma stages

Hodgkin lymphoma is diagnosed by stages and categories. The stages—I, II, III and IV—are determined by how much the disease has spread from a single lymph node region to the rest of the body. The categories—A, B, E, S and X—measure the presence of certain symptoms and to where in the body the disease may have spread.

Accurately diagnosing the stage and category of Hodgkin lymphoma is an important factor in evaluating treatment options. Our doctors use a variety of diagnostic tests to evaluate Hodgkin lymphoma and develop an individualized treatment plan tailored to each patient’s needs.

The stages of Hodgkin lymphoma are:

Stage I (stage 1 Hodgkin lymphoma): The cancer has only affected one lymph node region or organ.

Stage II (stage 2 Hodgkin lymphoma): Two or more lymph nodes are affected. The cancer is either above or below the diaphragm.

Stage III (stage 3 Hodgkin lymphoma): The cancer may affect lymph nodes on both sides of the diaphragm.

Stage IV (stage 4 Hodgkin lymphoma): Cancer cells have moved beyond the lymph system into other tissues and organs, such as the liver, lungs or bones.

Staging categories

In addition to stages, these letters are used to indicate the presence or absence of certain symptoms and/or how far the cancer has spread beyond the lymph nodes:

A indicates no symptoms have developed.

B is used when any of the following symptoms have developed: unexplained weight loss, drenching night sweats or fever.

X is used when the disease is considered “bulky,” with large tumors, greater than 10 cm in size, spanning the chest region.

E indicates extranodal cancers that have spread beyond the lymph nodes into other tissues or organs.

S is used when the cancer has spread to the spleen. Approximately 30 percent of Hodgkin lymphoma patients will develop an enlarged spleen (splenomegaly).

Next topic: How is Hodgkin lymphoma diagnosed?

After the Cure: Survival Rates for Lymphomas Are High, but Patients Need to Consider Long-Term Effects

Lymphoma survivors need to monitor their health carefully in the years after treatment. Alamy

There are very few cancers for which doctors will use the word cure right off the bat, but Hodgkin lymphoma (HL), the most common cancer diagnosis among children and young adults, comes pretty darn close: Ninety percent of patients with stages 1 and 2 go on to survive five years or more; even patients with stage 4 have a 65 percent survival rate.

“When patients come in with Hodgkin lymphoma, especially, the provider is likely to say, ‘You’re lucky. This is a highly curable type,” says Michael Roth, MD, the director of the Childhood Cancer Survivorship Program at University of Texas MD Anderson Cancer Center in Houston.

What a doctor may not say is that HL also leads to very high incidences of later-in-life diseases, particularly when patients are children when diagnosed. “We now know that obtaining a cure for lymphoma isn’t enough,” says Dr. Roth. “You also have to maximize patients’ quality of life over the long term.”

Early Curative Treatments for Lymphoma Raised the Risk for Other Diseases

For years, the standard of care for treating HL was to use a combination of radiation and chemotherapy, a one-two punch that blasted cancer cells and could also have a seriously destructive impact on surrounding healthy cells.

“We took a bazooka approach, but that approach increased the risk for a host of medical complications, including cardiac issues, lung disease, infertility, secondary blood cancers, thyroid cancer, and breast cancer,” says Lisa Roth, MD, the director of the adolescent and young adult lymphoma program at New York–Presbyterian and Weill Cornell Medicine in New York City.

For instance, doctors now believe that breast tissue in girls and teenagers may be especially sensitive to radiation. “We’ve found that breast cancer is prevalent in lymphoma patients who received radiation at a young age,” says Dr. Lisa Roth.

This unexpected fallout has led to a major shift in the management of Hodgkin lymphoma — one that calls for less radiation, when possible, as well as targeted treatments that harness the body’s immune system to attack only tumor cells and leave healthy cells in peace.

Monitoring Long-Term Effects on the Heart

It’s heartbreaking enough for any child to get a cancer diagnosis, but survivors of HL who are diagnosed as children or teens are especially prone to serious heart conditions as adults.

A report published in the June 2015 issue of JAMA found that HL patients have a four- to sixfold increased incidence of congestive heart disease or heart failure compared with the general population. (1)

They are also more likely to develop valve abnormalities and have heart attacks in their thirties, forties, and fifties. “These survivors are getting diseases of the elderly at an earlier stage,” says Michael Roth. “The chemotherapy and radiation to the chest appear to be speeding up the aging process in organs more targeted by those treatments, like the heart.”

A class of chemotherapy drugs known as anthracyclines, which include drugs such as Adriamycin (doxorubicin) and Ellence (eprubicin) is also now known to be cardio toxic. (2) “Anthracyclines trigger the release of free oxygen that damages cells, including heart cells,” says Michael Roth. Along with his MD Anderson colleagues, Roth is investigating whether first giving patients a cardio-protective drug known as dexrazoxane (Zinecard, Totect) before chemotherapy can head off heart problems later. “The data is still coming in, but the early evidence is promising,” he says.

Findings like these have spawned an emerging field known as cardio-oncology, which aims to reduce the unhealthy heart effects produced by so many cancer treatments.

“Monitoring these problems is an important part of cancer survivorship,” says Michael Roth. “Years ago, we didn’t know the side effects of being exposed to radiation and chemotherapy. Now we are trying to take action on the back end, by doing regular screenings — including echocardiograms and EKGS — on these patients who were treated back in the ’70s and ’80s.” The goal? “To try to catch abnormalities early on.”

Patients in MD Anderson’s Childhood Cancer Survivorship Program come back regularly, and are given screenings based on how much radiation they received, or their age during treatment, or any number of factors,” says Michael Roth. “For Hodgkin lymphoma, this kind of post-cancer follow-up is now the standard of care.”

RELATED: CAR T Cell Therapy Enhances the Human Immune Response to Cancer

The Future of Care: Avoid Doing Damage in the First Place

For young patients getting a diagnosis of Hodgkin lymphoma now, oncologists are offering more targeted, individualized treatments.

“When we do use radiation, we use lower doses,” says Lisa Roth. “And the technology has gotten much better at allowing us to home in on just the areas that need the radiation, rather than hitting healthy tissue.”

Many patients no longer get radiation at all. Often, they begin with chemo. If scans at the halfway point show that they’re responding quickly and their tumors are shrinking, they may forgo radiation — and the dangers that come with it.

Doctors are also looking beyond chemotherapy to immunotherapy, which enhances a patient’s own immune response to a tumor. One example: Antibodies from a patient’s immune system might be used to pummel certain proteins on the surface of cancer cells.

“We’ve seen encouraging responses with an immunotherapy drug called Keytruda (pembrolizumab), which is what’s called a checkpoint inhibitor,” Lisa Roth explains. “It works by changing the interaction between the tumor and the immune system so that the latter can fight the cancer cells more effectively.” (3)

Meanwhile, a trial at MD Anderson is looking at subbing in a new drug for the chemotherapy agent bleomycin, which has been shown to cause lung damage. They are trying a medication known as brentuximab. (4) “It’s an antibody that targets a protein on the surface of tumor cells, and is safer for the lungs,” MD Anderson’s Michael Roth explains.

Another new treatment, known as CAR T cell therapy (CAR stands for chimeric antigen receptor), has shown promise in treating acute leukemia as well as non-Hodgkin lymphoma. “Basically, we take out a patient’s immune system, edit it so that it will target tumor cells, then put it back into the body,” says Michael Roth.

Of course, researchers still don’t know if immunotherapy will produce side effects in 10, 20, or 50 years’ time. “We will have to do that surveillance, too,” Michael Roth admits.

Still, he says, “there’s hope to be seen. Some of the changes we’ve made — decreasing radiation, limiting chemotherapy doses, using more targeted therapies — are already resulting in patients living longer — with a better quality of life. It’s not just about curing the cancer anymore.”

What Is the Treatment for Hodgkin Lymphoma?

The goal of treatment for Hodgkin lymphoma is to eradicate the lymphoma cells without damaging normal cells in order to minimize treatment side effects. Talk with your doctor about any treatment-related side effects you experience.

The most common treatment for Hodgkin lymphoma is chemotherapy (drugs). Immunotherapy is sometimes used, while the use of radiation therapy has diminished over the years.

Patients with Hodgkin lymphoma that is resistant to treatment or returns after initial treatment may need autologous stem cell transplantation. In this procedure, higher doses of chemotherapy or total body irradiation are applied in an effort to destroy Hodgkin lymphoma cells that have survived standard therapy. As a side effect, the higher doses of therapy are likely to destroy normal blood and bone marrow cells. Therefore, normal bone marrow stem cells are taken from the patient’s bloodstream before he or she undergoes chemotherapy or radiation. The stem cells are then frozen and saved and returned to the body intravenously after the treatment in order to repopulate the bone marrow.

A new drug, brentuximab vedotin (Adcetris), is designed to treat patients whose lymphoma has progressed after treatment with bone marrow stem cell transplantation or those who have had two chemotherapy treatments and are not eligible for transplant. It’s the first new drug approved to treat Hodgkin lymphoma in over 35 years.

A recent analysis of survival outcomes for patients with advanced-stage Hodgkin lymphoma (HL) has shown reduced mortality rates with time, but it has also highlighted a continued need for improvement in survival rates. The study results were reported in The Oncologist.

The research team conducting the study examined data from the Surveillance, Epidemiology, and End Results database for 9042 adult patients treated with chemotherapy for stage 3 or 4 classic HL. The researchers conducted analyses of overall survival (OS) over time. For these analyses, the years during which the patients were diagnosed were divided into 5-year intervals (2000 to 2004, 2005 to 2009, and 2010 to 2014).

The median age of patients included in the analysis was 41.0 years. The 3-year OS rate for this population rose from 78.5% in the period between 2000 and 2004 to 81.8% in the period between 2010 and 2014 (P =.0008).

Initial treatment with radiation declined from a rate of 21.3% in the period between 2000 and 2004 to 10.7% in the period between 2010 and 2014. However, the rate of death by cardiovascular causes and the incidence of second primary malignancy did not significantly decrease over time.

Patient age showed an association with OS, with younger patients showing higher survival rates compared with older patients. The 3-year OS rate was lower for patients over 60 years of age throughout the years of study, but it increased to 58.6% in the period between 2010 to 2014, compared with 48.6% during the period of 2000 to 2004.

Multiple demographic variables, including socioeconomic factors, appeared to affect survival outcomes, which the researchers considered evidence of unmet needs in the treatment of this condition.

“Survival of patients with advanced-stage HL has continued to improve over time, suggesting the clinical of novel therapies and improved treatment approaches,” the authors concluded. However, they noted that other researchers have reported 5-year OS rates of 90%, suggesting that the 3-year population-level OS in this patient population can be improved further.

Reference

1. Guru Murthy GS, Szabo A, Hamadani M, Fenske TS, Shah NN. Contemporary outcomes for advanced-stage classical Hodgkin lymphoma in the U.S.: analysis of Surveillance, Epidemiology, and End Results database . Oncologist. doi:10.1634/theoncologist.2019-0172

ON THIS PAGE: You will find information about the number of people who are diagnosed with NHL each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors. Use the menu to see other pages.

This year, an estimated 74,200 people (41,090 men and 33,110 women) in the United States will be diagnosed with NHL. While some subtypes of NHL are common in children, NHL is far more common in adults and risk increases with age. Over half of patients are age 65 or older when diagnosed. NHL is the seventh most common cancer in both men and women. The disease accounts for 4% of all cancers in the United States.

It is estimated that 19,970 deaths (11,510 men and 8,460 women) from this disease will occur this year. It is the ninth most common cause of cancer death among both men and women. The survival rate has been improving since the late 1990s, thanks to treatment advances. From 2007 to 2016, the death rate decreased by 2% annually.

The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The overall 5-year survival rate for people with NHL is 71%. For men, the 5-year survival rate is 69%. For women, it’s 72%. For stage I NHL, the 5-year survival rate is almost 82%. For stage II the 5-year survival rate is 75% and for stage III it is 69%. For stage IV NHL, the 5-year survival rate is almost 62%. These survival rates vary depending on the cancer’s stage and subtype.

It is important to remember that statistics on the survival rates for people with NHL are an estimate. The estimate comes from annual data based on the number of people with this cancer in the United States. Also, experts measure the survival statistics every 5 years. So the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society’s (ACS) publications, Cancer Facts & Figures 2019 and Cancer Facts & Figures 2017, the ACS website (January 2019), and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by NHL. Use the menu to choose a different section to read in this guide.

Hodgkin lymphoma

Find out about survival for Hodgkin lymphoma.

Survival depends on many different factors. So no one can tell you exactly how long you will live. It depends on your:

  • type and stage of cancer
  • level of fitness
  • previous treatment

These are general statistics based on large groups of patients. Remember, they can’t tell you what will happen in your individual case.

Your doctor can give you more information about your own outlook (prognosis). You can also talk about this with the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.

Survival by stage

No UK-wide statistics are available for different stages of Hodgkin lymphoma or individual treatments.

The following statistics come from a 2012 British review paper about Hodgkin lymphoma and are based on the results from large international trials.

Stage 1 and stage 2

More than 90 out of 100 people (more than 90%) survive for 5 years or more after diagnosis.

Stage 3 and stage 4

Between 75 and 90 out of 100 people (between 75 and 90%) will survive for 5 years or more after they’re diagnosed.

Even if Hodgkin lymphoma comes back, it can often be treated successfully again. It’s slightly less likely to be cured if it has come back. But treatment can still often keep it under control for long periods (years) at a time.

Hodgkin’s lymphoma in adults
W Townsend and D Lynch
The Lancet, 2012, Volume 380, Issue 9844

Survival for all stages

Generally, for people with Hodgkin lymphoma in England and Wales:

  • around 90 out of 100 (around 90%) survive their cancer for 1 year or more after diagnosis
  • almost 90 out of 100 (almost 90%) survive their cancer for 5 years or more after diagnosis
  • 80 out of 100 people (80%) survive their cancer for 10 years or more after they are diagnosed

Statistics provided by the Statistical Information Team at Cancer Research UK.

What affects survival

Your outcome depends on the stage of the lymphoma at diagnosis. This means where the lymphoma is in your body and whether it has spread. Your stage also depends on whether you had certain symptoms when you were diagnosed, such as weight loss, night sweats, or high temperatures.

Your sex and age also affect outlook. Hodgkin lymphoma survival is higher in women than men. And survival is highest for people diagnosed aged under 40 years old.

About these statistics

The terms 1 year survival and 5 year survival don’t mean that you will only live for 1 or 5 years. They relate to the number of people who are still alive 1 year or 5 years after their diagnosis of cancer.

Some people live much longer than 5 years.

The 1, 5 and 10 year survival statistics for all stages of Hodgkin lymphoma are for relative survival. Relative survival takes into account that some people will die of causes other than cancer. This gives a more accurate picture of cancer survival.

Clinical trials

Research into treatments is continuing to improve the outlook for people with Hodgkin lymphoma. We have detailed information about clinical trials on this website. You can also search our clinical trials database for UK trials into Hodgkin lymphoma.

More statistics

Read more about understanding cancer statistics and incidence, mortality and survival statistics.

For more in depth information about survival and other statistics for Hodgkin lymphoma, go to our Cancer Statistics section.

Lymphoma is a type of cancer that affects the lymphatic system and lymph nodes, which are crucial for the circulatory and immune systems. The disease is usually characterized by the existence of swollen lymph nodes, particularly in the regions of the neck and armpits. Night sweats, chills or fevers, unexpected weight loss, loss of appetite, lack of energy or tiredness, itching or rash, coughing, difficulties in breathing, enlarged tonsils, and headaches are other common signs of the disease.

There are different types of lymphomas, which determine the treatment and survival of patients. The past decades observed an increase in survival associated with lymphoma, which is considered the fastest growing and one the most common cancer types in the US. Survival has increased particularly in cases of early detection. Despite this fact, it is worth noting that the rates are conditioned by the time frame, which means that the statistics include a determined period and do not consider deaths after that period.

Lymphoma’s Incidence and Mortality

Currently, almost 93% of the patients suffering from regionally contained disease survive five years following the diagnosis, according to the National Cancer Institute, which may be explained by more accurate methods of diagnosis and cutting edge discoveries in the field. There are about 65.500 new lymphoma diagnoses annually in the US alone. From the total, about 20.000 people die due to the disease. The average age of diagnosis is 66 years old and the probability of suffering from the disease raises proportionally with age. The probability is also higher among men than women, while the average death age is 75.

Lymphoma’s Survival Rate by Disease Stage

The Surveillance Epidemiology and End Results (SEER) of the National Cancer Institute reveals the five year relative survival tendency of patients who suffer from lymphoma. Early-stage (I) with localized disease has a 81.1% survival rate, while early-stage (I, II) with regional disease has a 70.5% survival rate, and later-stage (III, IV), metastasized disease is 58.5%. The increase in survival rate is considered a success of cancer research. In addition to timing, the survival rate of lymphoma patients is also conditioned by the type of lymphoma in question and treatment chosen.

Note: Lymphoma News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Lymphoma survival rates

There are many types and subtypes of lymphoma, each requiring a specialized treatment. Lymphoma patients who choose Seattle Cancer Care Alliance (SCCA) receive expertly targeted and delivered care, along with access to new therapies explored in clinical studies conducted at SCCA and its founding organizations, Fred Hutch and UW Medicine.

If you do have lymphoma, where you choose to go for initial treatment has a significant impact on your likelihood of survival. Lymphoma patients at SCCA have access to advanced therapies and treatments being explored in several dozen ongoing clinical trials for lymphoma conducted at Fred Hutch and UW Medicine. For people with lymphoma who are good candidates for stem cell transplants, the Fred Hutch Transplant Program at SCCA is the most experienced transplant center in the world. As you can see below, patients treated for lymphoma at SCCA have high five-year survival rates.

Below are the five-year survival rates for lymphoma patients treated by SCCA compared to patients who were treated for lymphoma elsewhere. This information was collected by the National Cancer Data Base (NCDB) for patients who were diagnosed and treated between 2003 and 2006 and then followed for five years.

Stage I Lymphoma

  • SCCA patients are represented by the green line. Their five-year survival rate was 82 percent from the time they were first diagnosed by SCCA. Note that only patients who received all of their care from SCCA are included.
  • Patients from the other types of treatment centers—Community Cancer Centers, Comprehensive Community Cancer Centers, and Academic/Research Hospitals—are represented by the yellow line. Their five-year survival rate was 71 percent.

Stage II Lymphoma

  • SCCA patients are represented by the green line. Their five-year survival rate was 88 percent from the time they were first diagnosed by SCCA. Note that only patients who received all of their care from SCCA are included.
  • Patients from the other types of treatment centers—Community Cancer Centers, Comprehensive Community Cancer Centers, and Academic/Research Hospitals—are represented by the yellow line. Their five-year survival rate was 65 percent.

Stage III Lymphoma

  • SCCA patients are represented by the green line. Their five-year survival rate was 63 percent from the time they were first diagnosed by SCCA. Note that only patients who received all of their care from SCCA are included.
  • Patients from the other types of treatment centers—Community Cancer Centers, Comprehensive Community Cancer Centers, and Academic/Research Hospitals—are represented by the yellow line. Their five-year survival rate was 58 percent.
  • Note: While the SCCA survival rates appear to be better for stage III lymphoma, the data could not be statistically validated.

Stage IV Lymphoma

  • SCCA patients are represented by the green line. Their five-year survival rate was 72 percent from the time they were first diagnosed by SCCA. Note that only patients who received all of their care from SCCA are included.
  • Patients from the other types of treatment centers—Community Cancer Centers, Comprehensive Community Cancer Centers, and Academic/Research Hospitals—are represented by the yellow line. Their combined five-year survival rate was 49 percent.

The charts above include patients who were diagnosed between 2003 and 2006 and then followed for five years. The five-year observed survival rates are estimated using the actuarial method with one-month intervals. The endpoint is death from any cause (not cancer specific death); patients may have died from causes unrelated to their cancer. Calculations were performed using the NCDB Survival Reports software tool. Survival rates are not displayed when fewer than 30 cases are available, as survival rates calculated from small numbers of cases can yield misleading results and may have very wide confidence intervals.

The outcomes presented in the figures are not risk-adjusted. That is, the NCDB did not account for demographic differences (e.g., age at diagnosis, gender, socioeconomic status, and insurance status), prognostic factors, and comorbidities for SCCA and other hospitals. Also, the NCDB did not account for subjective differences in staging practices among hospitals. For example, it is possible that a cancer considered stage I at one hospital might be considered stage II at another hospital due to practice pattern variations. The outcomes comparisons presented here might have differed if the NCDB had accounted for such demographic and staging differences in our analyses.

The NCDB tracks the outcomes of 70 percent of all newly diagnosed cancer in the United States from more than 1,500 commission-accredited cancer programs. It has been collecting data from hospital cancer registries since 1989 and now has almost 30 million records.

Frequently Asked Questions

Data Collection Methodology

Non-Hodgkin lymphoma

Find out about survival for non-Hodgkin lymphoma (NHL).

Survival depends on many different factors. So no one can tell you exactly how long you will live. It depends on your:

  • type and stage of cancer
  • level of fitness
  • previous treatment

These are general statistics based on large groups of patients. Remember, they can’t tell you what will happen in your individual case.

Your doctor can give you more information about your own outlook (prognosis). You can also talk about this with the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.

Survival for all non-Hodgkin lymphomas

Generally, for people with non-Hodgkin lymphoma in England and Wales:

  • about 80 out of every 100 people (about 80%) survive their cancer for 1 year or more after they are diagnosed
  • around 70 out of every 100 people (around 70%) survive their cancer for 5 years or more after diagnosis
  • almost 65 out of every 100 people (almost 65%) survive their cancer for 10 years or more after they are diagnosed

Statistics provided by the Statistical Information Team at Cancer Research UK.

These statistics are for relative survival. Relative survival takes into account that some people will die of causes other than cancer. This gives a more accurate picture of cancer survival.

Survival for low grade NHL

Low grade lymphomas can be difficult to get rid of completely. But they can be kept under control for several years.

There are no UK-wide survival statistics available for the different types and stages of NHL.

Survival statistics are available for each stage of follicular and marginal zone lymphoma in one area of England. These are for people diagnosed between 2004 and 2011.

Follicular lymphoma is the most common type of low grade lymphoma.

Stage 1

Around 90 out of every 100 people (around 90%) survive for 5 years or more after they are diagnosed.

Stage 2

Almost 90 out of 100 people (almost 90%) survive for 5 years or more after diagnosis.

Stage 3 and stage 4

Almost 80 out of 100 people (almost 80%) survive for 5 years or more after they are diagnosed.

Marginal zone lymphomas are slow growing B cell lymphomas.

Around 80 out of 100 people (around 80%) will survive for 5 years or more after they are diagnosed.

75 out of 100 people (75%) will survive for 5 years or more after they are diagnosed.

Stage 3

More than 50 out of 100 people (more than 50%) will survive for 5 years or more after they are diagnosed.

Stage 4

Around 65 out of 100 people (around 65%) will survive for 5 years of more after their diagnosis.

These figures show that more people with stage 4 marginal zone lymphoma survive for 5 years or more compared to people with stage 3 disease. This could be because a number of other factors (not just stage) play a part in a person’s outcome. For example, the treatments people have and certain features of their lymphoma also influence survival.

There are different types of marginal zone lymphomas. These are:

  • extranodal marginal zone B-cell lymphoma, also known as mucosa-associated lymphoid tissue (MALT) lymphoma
  • nodal marginal zone B-cell lymphoma
  • splenic marginal zone B-cell lymphoma

Extranodal marginal zone B-cell lymphomas have a slightly better outcome than the other types. Almost 90 out of 100 people with this type of marginal zone lymphoma (90%) survive for 5 years or more after they are diagnosed.

Haematological Malignancy Research Network (HMRN)
Accessed February 2018

The HMRN statistics are for relative survival. Relative survival takes into account that some people will die of causes other than cancer. This gives a more accurate picture of cancer survival.

Non-Hodgkin lymphoma
K Shankland and others
Lancet. 2012 September Volume 380, Issue 9844, Pages 848-57

Survival for high grade lymphomas

High grade (aggressive) lymphomas generally need more intensive treatment than the low grade types. But they often respond well to treatment. Many people are cured.

There are no UK-wide survival statistics available for the different types and stages of NHL. Survival statistics are available for each stage of diffuse B cell lymphoma in one area of England. These are for people diagnosed between 2004 and 2011.

Diffuse large B cell lymphoma is the most common type of high grade lymphoma.

Around 65 out of 100 people (around 65%) survive for 5 years or more after they are diagnosed.

Around 70 out of 100 people (around 70%) survive for 5 years or more after they are diagnosed.

Over 50 out of 100 people (over 50%) survive for 5 years or more after they are diagnosed.

Almost 50 out of 100 people (almost 50%) survive for 5 years or more after they are diagnosed.

These figures show that more people with stage 2 diffuse large B cell lymphoma survive for 5 years or more compared to people with stage 1 disease. This could be because a number of other factors (not just stage) play a part in a person’s outcome. For example, the treatments people have and certain features of their lymphoma also influence survival.

Burkitt lymphoma is a less common type of high grade lymphoma which can grow quite quickly.

We don’t have statistics for the different stages of Burkitt lymphoma. But overall, almost 60 out of 100 people with Burkitt lymphoma (almost 60%) survive their cancer for 5 years or more after they are diagnosed.

Haematological Malignancy Research Network (HMRN)
Accessed February 2018

These statistics are for relative survival. Relative survival takes into account that some people will die of causes other than cancer. This gives a more accurate picture of cancer survival.

What affects survival

Your outcome depends on the stage of the lymphoma when it was diagnosed. The stage tells you about the number and places in the body that are affected by lymphoma.

The type and grade also affects your likely survival. Grade is very important. It means how abnormal the cells look under the microscope. Low grade lymphomas tend to grow slower than high grade lymphomas.

A number of other factors also affect your outlook.

Follicular Lymphoma International Prognostic Index (FLIPI)

For follicular lymphoma, doctors use a scale called the Follicular Lymphoma International Prognostic Index (FLIPI). It has 5 prognostic factors that doctors use to plan treatment and predict how people may respond to treatment. These 5 factors are:

  • being older than 60 years
  • having stage 3 or 4 follicular lymphoma
  • having a low red blood cell (haemoglobin) level
  • having more than 4 areas of lymph nodes affected with lymphoma
  • a higher than normal blood level of an enzyme called LDH (serum lactate dehydrogenase)

If you have no poor prognostic factors you have a score of 0. People with all of the poor prognostic factors have a score of 5. The doctor uses this score to divide people with follicular lymphoma into 3 groups:

  • low risk if you have no or 1 poor prognostic factor
  • intermediate (moderate) risk if you have 2 poor prognostic factors
  • high risk, if you have 3 or more poor prognostic factors

Prognostic index for diffuse large B cell lymphoma

For diffuse large B cell lymphoma, doctors group these factors together to make a prognostic index. A prognostic index is a way of trying to decide who has a greater risk of their lymphoma coming back after treatment.

This scale is only for people with diffuse large B cell lymphomas – not for people with low grade lymphomas.

To work out the prognostic index, you score one point for each of the following:

  • aged over 60
  • stage 3 or 4 lymphoma at diagnosis
  • a higher than normal blood level of an enzyme called LDH (lactate dehydrogenase)
  • performance status of more than 2 (see below)
  • non-Hodgkin lymphoma in more than one site outside your lymphatic system (in your bones, for example)

Performance status is a scoring system that describes how well you are and how much you can look after yourself.

0 means you are fully active and well. Your performance status will be more than 2 if you need to stay in bed or a chair for more than half the day and need a lot of help to look after yourself.

If you have no poor prognostic factors you have a score of 0. People with all of the poor prognostic factors have a score of 5.

  • A score of 0 or 1 means you are more likely to respond well to treatment, and your lymphoma is unlikely to come back.
  • A score of 2 means you are at moderately low risk of your lymphoma coming back.
  • A score of 3 means you have a moderately high risk of the lymphoma coming back.
  • A score of 4 or 5 means you are at a higher than average risk of not responding to treatment, or of having your lymphoma come back after treatment.

Both indexes was created before doctors used rituximab to treat lymphoma. Rituximab has improved treatment for many people with NHL. Doctors generally still think these indexes are useful tools to help plan treatment and predict outcome.

The terms 1 year survival and 5 year survival don’t mean that you will only live for 1 or 5 years. They relate to the number of people who are still alive 1 year or 5 years after their diagnosis of cancer.

Some people live much longer than 5 years.

Taking part in clinical trials can help to improve the outlook for people with non-Hodgkin lymphoma.

Treatments by NHL Stage

The best treatment for you depends on:

  • Your stage and prognostic factors
  • The type of NHL you have
  • Any gene changes found in your cancer cells
  • Specific proteins found in your cancer cells
  • Your overall health
  • Symptoms or lymphoma-related problems you have
  • Your treatment preferences

But there are some standard treatment approaches for specific stages of NHL:

Stage I and stage II: You’ll most likely have chemotherapy, with or without other treatments, such as immunotherapy, targeted therapy, and radiation therapy. Surgery may be an option for people with some subtypes of NHL, but this is rare.

If you have a subtype of NHL that grows very slowly, you may not need treatment right away. In this case, your doctor may watch the lymphoma closely over several months and then start treatment if it starts to grow.

Stage II with bulky disease, stage III, and stage IV: Chemotherapy, along with immunotherapy, targeted therapy, and/or radiation therapy, are the treatments doctors usually recommend for these stages of NHL.

You might need intrathecal chemotherapy if there’s a risk the lymphoma could spread to the fluid around your brain and spinal cord. To have this treatment, your care team will put a thin needle between the bones of your lower back and put the chemo drugs right into your spinal fluid.

A stem cell transplant might be an option for some types of NHL, or if the disease comes back after treatment. This procedure involves taking out and saving immature blood cells called stem cells. You can use your own stem cells or get them from a donor. Then, you get high doses of chemotherapy and radiation to kill all the lymphoma cells in your body. After that, the stem cells go into your body, where they grow and rebuild healthy blood cells over time.

Tumor lysis syndrome may be a risk if you have bulky disease. It happens when chemotherapy kills a lot of cancer cells in a short time, and the cell waste quickly builds up in your blood. Your doctor will use drugs, extra fluids, and blood tests to help prevent and watch for signs of tumor lysis syndrome.

Clinical trials: There are many different treatments for NHL, and scientists are testing new ones in research studies called clinical trials. If you join one, you will get the best standard treatment available, and maybe a new treatment that the researchers are testing. Talk to your doctor if you’d like to learn more about clinical trials or find one that may be right for you.

Adult Non-Hodgkin’s Lymphoma: Outlook / Prognosis

What is the outlook for people with adult non-Hodgkin’s lymphoma (NHL)?

The outlook for people with this disease depends upon the stage of the cancer. Another factor is the type of lymphoma present. The age and general health of the patient also are taken into account. In general, the survival rate of patients with NHL at the five-year mark is generally favorable

Other facts:

  • Indolent NHLs have a median survival rate of as long as 20 years, and Stage I and Stage II varieties can often be treated with radiation alone.
  • When treated early, over half of patients with aggressive NHL can be cured with combination chemotherapies.

Can non-Hodgkins’s lymphoma (NHL) come back?

Yes. Most relapses of aggressive NHL occur within two years of treatment. Relapses of indolent lymphoma can occur later.

NHL might recur in two types of situations. In one, the NHL was never completely cured during treatment and so requires additional kinds of treatment. In the second, the disease was put into remission and then returns. This is called relapsed disease. It might happen because the slow-growing cells of low-grade lymphoma might not be affected by the treatment (which tends to kill faster-growing cells).

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