Non-Hodgkin Lymphoma: It’s More Than Just One Type

B cells make proteins called antibodies that protect your body against bacteria, viruses, and other germs. Germs have a protein called an antigen on their surface, to which the antibody attaches. That signals your immune system to attack the invading organism.

If you live in the United States and are diagnosed with non-Hodgkin lymphoma, there's a good chance it's the B-cell variety. About 85% of all lymphomas diagnosed in North America are B-cell lymphomas. And in the United States, these cancers affect white people more often than African Americans or Asian people.

T-cell lymphomas are more common in other parts of the world, such as Asia. That may have to do with causes that are unique to those regions, Dr. Vose says.

Doctors further divide B-cell lymphomas into a few subtypes:

Diffuse large B-cell lymphoma is the most common type. One out of every three people diagnosed with lymphoma in the United States has this type. If you have diffuse large B-cell lymphoma, the first sign might have been a swollen gland in your neck, armpit, or belly. This is a fast-growing cancer, but it is treatable. In many people, it's curable.

Follicular lymphoma is the second most common type of lymphoma, and it usually starts later in life. Although it's not as curable as diffuse large B-cell lymphoma, it grows slowly. "Patients often have symptoms for months or years before they’re diagnosed," Dr. Vose says. Some people with this cancer don't need to start treatment right away. People who do go on treatment have a good likelihood of going into remission.

Chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) are variations on the same type of cancer. They both affect a cell called a small lymphocyte. The difference is, CLL cells are in the blood and bone marrow, while SLL cells are in the lymph nodes and spleen. Both cancers grow so slowly that many people live for decades with them.

Mantle cell lymphoma is a relatively rare cancer. It can be challenging to treat, because it grows quickly and it doesn't respond as well to cancer drugs as some of the other lymphomas. But researchers are working on new therapies that will hopefully improve survival for people who are diagnosed with this cancer.

Marginal zone lymphomas start in cells that look small under the microscope. This is a group of cancers that tend to grow slowly.

There are other types of B-cell lymphomas, including Burkitt lymphoma and hairy cell leukemia, but they are rare.

What Are T-Cell Lymphomas?

The other category of non-Hodgkin lymphoma are the T-cell lymphomas. T cells either destroy germs themselves, or boost the activity of other immune cells. These types of lymphomas are much less common than B-cell cancers, affecting only about 15% of people with non-Hodgkin lymphoma.

T-cell lymphoma comes in different types, and all of them are pretty rare.

T-lymphoblastic lymphoma/leukemia affects mostly teens and young adults. It grows quickly, but is very curable.

Peripheral T-cell lymphomas are a group of cancers that develop in mature T cells. Depending on the type, they can affect a variety of organs, including the skin, lungs, and intestines. Some of these cancers grow faster than others.

Next Steps

Once your doctor has identified which type of non-Hodgkin lymphoma you have, you'll talk about treatments. Which therapy your doctor recommends will depend on your cancer type, where it is in your body, and how aggressive it is. Make sure you understand why your doctor has suggested a particular treatment and how it might help you before moving forward.

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