Medically reviewed by Ann S. LaCasce, MD, MMSc
Non-Hodgkin lymphoma (NHL) is a type of cancer that forms in the lymph system, part of the body’s immune system. There are many kinds of NHL that develop from various types of white blood cells, including B cells, T cells, and NK cells. The majority of NHL are B cell in origin. The most common types of NHL in adults are diffuse large B-cell lymphoma, which grows rapidly, and follicular lymphoma, which grows slowly.
What are the symptoms? Although some patients with lymphoma report no physical symptoms, they may be found to have enlarged lymph nodes or abnormal blood counts. Some patients may experience drenching sweats, fever, weight loss (particularly in fast-growing lymphomas), and fatigue.
How is it treated? Treatments may include:
- Radiation therapy
- Stem cell transplant
- Targeted therapy
Some patients with slow-growing lymphomas may be observed in a process called “watchful waiting,” rather than having immediate treatment.
Chronic lymphocytic leukemia
Chronic lymphocytic leukemia (CLL) is a slow-growing cancer that develops when the bone marrow makes too many B lymphocytes, a type of white blood cell. It most often occurs in middle aged or older adults.
What are the symptoms? Many individuals with CLL will not have symptoms, but some will experience fatigue, swelling of the lymph nodes in the neck, and weight loss.
How is it treated? Patients with CLL are most often treated with chemotherapy, including a number of new oral drugs and immune-based therapies. Venetoclax, a new type of cancer drug known as a Bcl-2 inhibitor, for example, is showing great promise against a poor-prognosis form of CLL.
Acute myeloid leukemia
Acute myeloid leukemia (AML) is a fast-growing cancer in which the bone marrow produces abnormal amounts of white blood cells, red blood cells, and platelets. This is the most common acute leukemia in adults.
What are the symptoms? Early signs and symptoms of AML include fatigue and easy bruising or bleeding.
How is it treated? The standard treatment for adult AML includes chemotherapy alone, or chemotherapy followed by a stem cell transplant. AML treatment is often separated into remission-induction treatment, which is the first phase, and post-remission therapy, which works to kill any remaining leukemia cells and prevent recurrence.
Acute lymphoblastic leukemia
Acute lymphoblastic leukemia (ALL) is a fast-growing type of leukemia in which the bone marrow makes too many immature lymphocytes. Similar to AML, the white blood cells can be abnormally high or low, and often platelets and red blood cell counts are low.
What are the symptoms? Similar to AML, the early signs and symptoms of ALL include fever, fatigue, shortness of breath, and easy bruising or bleeding.
How is it treated? ALL, like AML, is broken into remission-induction and post-remission phases, and generally includes chemotherapy alone, or chemotherapy followed by a stem cell transplant once the patient is in remission. CAR T-cell therapy, as well as the drugs blinatumomab and inotuzumab, can also be options for certain patients.
Multiple myeloma occurs when the body makes too many plasma cells, which develop from B lymphocytes in the bone marrow. Too many plasma cells can result in less room for healthy red blood cells, white blood cells, and platelets, which can lead to anemia or infections.
What are the symptoms? Although some patients have no symptoms, signs of multiple myeloma can include bone pain (often in the back or ribs), fever, fatigue, frequent infections, and easy bruising or bleeding.
How is it treated? Myeloma may be treated using various chemotherapy and targeted therapy drugs including proteosome inhibitors, immunomodulatory drugs, and monoclonal antibodies, amongst others. Radiation therapy and stem cell transplantation may be an option for select patients.
The past two years have seen an increase of new treatments for lymphoma, leukemia, and multiple myeloma. Targeted therapies for the disease are now being studied in clinical trials at the Center for Hematologic Oncology at Dana-Farber/Brigham and Women’s Cancer Center, and researchers are improving outcomes in many patients with these forms of blood cancers.