Overview of care for adult survivors of non-Hodgkin lymphoma
- Matthew S Davids, MD, MMSc
Matthew S Davids, MD, MMSc
- Assistant Professor of Medicine
- Harvard Medical School
- David C Fisher, MD
David C Fisher, MD
- Assistant Professor of Medicine
- Harvard Medical School
Non-Hodgkin lymphoma (NHL) consists of a diverse group of malignant neoplasms of the lymphoid tissues variously derived from B cell progenitors, T cell progenitors, mature B cells, or mature T cells. In the United States, NHL is the fifth most common malignancy and the sixth most common cause of cancer death . There are a growing number of long-term survivors of NHL. This is predominantly due to an increasing incidence and improved survival after initial treatment:
●Approximately 71,000 people are diagnosed with NHL in the United States each year, and the incidence of the disease is on the rise, doubling since the 1970s, with a continued 1 to 2 percent increase per year this century . These increases have been seen predominantly in high-grade, potentially curable subtypes .
●NHL is often a disease of middle-aged and older adults, a demographic that continues to increase in size as the life expectancy of the general population increases.
●Improvements in initial therapy have increased survival rates for some NHL histologies, such as diffuse large B cell lymphoma. NHL survivors now commonly live for many years after completing curative therapy.
Despite improvements in treatment, NHL survivors are at risk of developing long-term complications of intensive therapy, including second malignancies, cardiovascular disease, endocrine dysfunction, and cognitive sequelae.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- PROGNOSIS AND NATURAL HISTORY
- OVERVIEW OF TREATMENT COMPLICATIONS
- Second malignancies
- Infertility and endocrine dysfunction
- - Gonadal dysfunction
- - Other endocrinopathies
- Neurologic and psychiatric complications
- POSTTREATMENT SURVEILLANCE
- Monitoring for relapse
- Monitoring for complications
- Lifestyle modifications
- COORDINATION OF CARE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS