The lymphatic system is a network of vessels, nodes (glands), and organs — including the spleen, thymus, and tonsils — that fights infection and drains fluid from body tissues. Lymphoma is cancer of the lymphocytes, the white blood cells that patrol this system. Non-Hodgkin lymphoma (NHL) is a broad group of more than 60 different lymphoma subtypes. The two main categories are B-cell lymphomas (the most common, including DLBCL and follicular lymphoma) and T-cell lymphomas. NHL can arise in lymph nodes anywhere in the body, as well as in the spleen, bone marrow, intestines, or other organs.
📄 የNCCN የሕሙማን ትምህርት ጽሑፍ
Non-Hodgkin Lymphoma
A cancer of the lymph system — often highly treatable when detected early
📚 በNCCN የሕሙማን መመሪያዎች® ላይ የተመሠረተ
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🌍 ለኢትዮጵያና ለምሥራቅ አፍሪካ ሁኔታ የተዘጋጀ
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👨⚕️ የስለ ካንሰር ቡድን
📖 What Is Non-Hodgkin Lymphoma?
🔍 Warning Signs & Symptoms
Common symptoms of NHL include:
- Painless, enlarged lymph nodes — lumps in the neck, armpit, or groin
- Fever that is unexplained and recurrent
- Drenching night sweats (soaking the bed sheets)
- Unexplained weight loss of more than 10% of body weight over 6 months
- Persistent fatigue and weakness
- Abdominal swelling or pain (enlarged spleen or abdominal lymph nodes)
- Chest tightness, cough, or difficulty breathing (mediastinal lymph nodes)
- Itching of the skin without rash
🩺 Diagnosis
Diagnosis requires a lymph node biopsy — a sample of an enlarged lymph node is surgically removed or a core needle biopsy is performed, and the tissue is examined by a pathologist. Immunohistochemistry (IHC) testing identifies the exact subtype, which is essential for choosing the right treatment. CT scan of the chest, abdomen, and pelvis determines the extent of disease. PET scan shows where active cancer is in the body. Bone marrow biopsy checks whether lymphoma has spread to the marrow. HIV testing should be performed in all patients in the East African context, as HIV significantly affects treatment planning.
📊 Staging — Ann Arbor System
NHL is staged using the Lugano (Ann Arbor) classification. Stage I: One lymph node region or one organ involved. Stage II: Two or more lymph node regions on the same side of the diaphragm. Stage III: Lymph nodes on both sides of the diaphragm involved. Stage IV: Widespread disease including bone marrow, liver, lungs, or other organs. The letters A (no symptoms) and B (fever, night sweats, weight loss) are added — B symptoms indicate more aggressive disease.
💊 Treatment Options
Treatment depends on the NHL subtype and stage. NCCN Guidelines recommend:
- R-CHOP chemotherapy — Rituximab + cyclophosphamide, doxorubicin, vincristine, prednisolone — standard for DLBCL
- R-CVP or bendamustine — For indolent (slow-growing) follicular lymphoma
- Radiation therapy — For localised Stage I–II disease, often combined with chemotherapy
- Autologous stem cell transplant — For relapsed or refractory aggressive lymphoma
- CAR-T cell therapy — Advanced option for relapsed DLBCL (where available)
- HIV management — Antiretroviral therapy (ART) is continued alongside lymphoma treatment in HIV-positive patients
- Watchful waiting — For very slow-growing (indolent) lymphomas that cause no symptoms
💚 Living With Lymphoma
R-CHOP chemotherapy can cause nausea, hair loss, fatigue, and increased infection risk. Eating protein-rich foods supports the immune system during treatment. Good hand hygiene helps prevent infections during periods of low white blood cell counts. Avoid crowds and people with active infections during chemotherapy cycles. Many patients with DLBCL achieve complete remission after 6 cycles of R-CHOP. Regular follow-up scans are performed every 3–6 months for the first 2 years after treatment.
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የሕክምና ማሳሰቢያ
ይህ ጽሑፍ ለትምህርት ዓላማ ብቻ ነው። በወቅታዊ የNCCN የሕሙማን መመሪያዎች® እና በWHO ምክሮች ላይ የተመሠረተና ለኢትዮጵያና ለምሥራቅ አፍሪካ ሁኔታ የተዘጋጀ ነው። ከብቁ የጤና ባለሙያ የሚሰጥ ምክርን፣ ምርመራን ወይም ሕክምናን አይተካም። የኢትዮጵያ ሕሙማን ለሕክምና በአዲስ አበባ የሚገኘውን የጥቁር አንበሳ ስፔሻላይዝድ ሆስፒታል ኦንኮሎጂ ክፍል ማማከር አለባቸው።