Lymphoma

Lymphoma is the name of cancer that develops in the lymphatic system.  The lymphatic system is an important part of the immune system.

What is Lymphoma?

Lymphoma is a type of blood cancer that originates in lymphocytes, which are a type of white blood cell. Generally lymphoma occurs within the lymph nodes, which are part of the lymphatic system (a network of tissues and vessels that help control the fluid in the body) which is part of the immune system.7 However in some cases lymphoma can arise in other organs. This is known as extra-nodal lymphoma.

The lymphatic system is made up of lymphocytes, of which there are 2 main types: B-lymphocytes (which help to make antibodies to help protect the body from infection) and T-lymphocytes (which help to regulate the body’s immune function). 7

Lymphoma develops as a result of abnormal growth and development in these lymphocyte cells. There are two types of lymphoma that can occur:

  • Hodgkin lymphoma (HL) – named after Dr Thomas Hodgkin who discovered the disease. It is rarer than non-Hodgkin lymphoma, and accounts for less than 1% of all cancers in Australia.4
    • Abnormal B lymphocyte cells known as Reed-Sternberg cells are the malignant cell in HL.7
    • Enlarged lymph nodes (most commonly around the neck) are usually noticed first.4
  • Non-Hodgkin lymphoma (NHL) – accounts for approximately 90% of lymphomas. There are more than 60 different subtypes.8

Types of Lymphoma

Non-Hodgkin lymphoma

Non-Hodgkin lymphoma accounts for approximately 90% of all lymphoma diagnoses and is the most common type of blood cancer in Australia.

There are many different sub types of non-Hodgkin lymphoma which are divided into ‘B-cell’ or ‘T-cell’ lymphomas. Both sup-types are cancers of the lymphatic system after the B or T lymphocytes (type of white blood cell) undergo a malignant change and multiple uncontrollably. These abnormal cells eventually form as tumours, most commonly in the lymph nodes of the body.

Hodgkin lymphoma

Hodgkin lymphoma is a rare cancer accounting for approximately 0.5% of all cancers diagnosed in Australia. While non-Hodgkin lymphoma can affect either the B or T cells, Hodgkin lymphoma is marked by the presence of Reed-Sternberg cells. Reed-Sternberg cells are malignant, mature B cells, and are unusually large.

Hodgkin lymphoma tends to progress quite predictably through lymph nodes and is commonly diagnosed in early stages.

A biopsy is the only way for doctors to confirm a Hodgkin lymphoma diagnosis.

Signs and symptoms of Lymphoma

Some common symptoms of lymphoma include; 2

  • Sweating at night
  • Tiredness
  • Itchy skin
  • Loss of weight and appetite
  • Swollen lymph nodes under the arms, neck or groin that are not painless
  • Temperature
  • Pain in the chest, coughing and/or trouble breathing
  • Chronic infection
  • Enlarged stomach due to swollen lymph nodes or spleen

Having one or all of these symptoms does not mean you have lymphoma, as many conditions can cause these symptoms. However, it is important if you do experience any of the above, to see your doctor. 2

Stages of lymphoma

The most common system used to stage lymphoma is the Ann Arbor Staging system, which includes 4 stages;10

  • Stage I – cancer cells have been found in only one group of lymph nodes
  • Stage II – two or more lymph node groups have been affected; however, they are localised to either the top or bottom half of the body
  • Stage III – two or more lymph node groups have been affected in both sides of the diaphragm.
  • Stage IV – lymph node groups are affected as well as one or more organs (such as bone marrow or liver).

Lymphoma research at Icon

Our research centre at Icon offers Australia the largest private clinical trials programme in cancer research, with over 35 clinical trials currently open for recruitment.  Clinical trials specific to lymphoma research can be found here.

Icon’s collaborative approach to clinical trial research not only enables continual advancement and breakthroughs in lymphoma research, but also enables the most up to date treatment options are available to all patients regardless of health insurance.

Treatments

Treatment of lymphoma will be dependent on your type of lymphoma, current health and medical history as well as your treatment preference.

If the lymphoma is fast growing (or aggressive) treatment will need to start straight away. 3

Common treatments for lymphoma include;3

  • Chemotherapy
  • Radiation therapy
  • Stem cell transplants
  • Targeted therapy
  • Monoclonal antibodies

Frequently asked questions

Is lymphoma hereditary?

There does appear to be an increased risk for developing lymphoma (both non-Hodgkin’s and Hodgkin’s) if there is a family history of the disease. 11

However, gene mutations that result in lymphoma seem to be acquired (happen over the course of a person’s life through exposure to virus’s and chemicals) rather than inherited. 11,12

Are there risk factors for lymphoma?
  • Hodgkin Lymphoma –
    • Being young (in your 20s) and also being slightly older (over 55 years)
    • Males have a slightly increased risk over females
    • Having the virus which causes AIDS (HIV) or Epstein Barr virus (causes glandular fever)
    • Family member (such as mother, father or sibling) with Hodgkin lymphoma
  • Non-Hodgkin lymphoma –
    • Being older (over 60 years)
    • Being male, although there are some types of Non-Hodgkin’s lymphoma which is more common in females
    • High intakes of fat and meat in the diet
    • Chemical exposure such as exposure to herbicides or pesticides and benzene
    • Autoimmune diseases such as rheumatoid arthritis
    • Infection with some viruses such as the HIV, Epstein Barr or HTLV-1 virus (Human T-cell leukaemia/lymphoma virus)
How common is lymphoma?

In 2018 there were just under 6,500 estimated cases of lymphoma diagnosed, with more men than women diagnosed. 1 Lymphoma is the sixth most common form of cancer in Australia. 3

Over the past 20 years there has been a steady increase in the number of lymphoma cases diagnosed, however research is yet to find a reason for this. 3

References

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