ℹ️ What are Lymphomas?

Lymphomas are cancers of the lymphatic system — a network of organs, nodes, and vessels that is part of the body's immune system. Unlike leukemias, which primarily involve circulating blood cells, most lymphomas form solid tumors in lymph nodes, the spleen, bone marrow, or other organs.

💊 Primary Treatment Approaches

Lymphoma treatment varies by subtype — from highly curative ABVD for Hodgkin Lymphoma to R-CHOP for aggressive NHLs and watch-and-wait for indolent forms:

🎗️ Hodgkin vs. Non-Hodgkin Lymphoma

Lymphomas are broadly divided into two major families based on the type of abnormal lymphocyte involved and the presence of specific cell types:

Hodgkin Lymphoma

• Defined by Reed-Sternberg cells — large, bi-nucleated B-cells
• Spreads in an orderly, contiguous pattern through lymph nodes
• Bimodal age distribution: peaks at 20–35 and again after 55
• One of the most curable cancers — 85%+ long-term survival
• Treated with ABVD or BV-AVD; PET-CT guides treatment intensity

NHL

Non-Hodgkin Lymphoma

• A large, diverse group of 60+ distinct lymphoma subtypes
• Can arise from B-cells (~85%) or T-cells (~15%)
• Ranges from indolent (follicular, watch-and-wait for years) to highly aggressive (DLBCL, requires immediate treatment)
• Anti-CD20 therapy (rituximab, obinutuzumab) is foundational for B-cell NHLs
• CAR T-cell therapies and bispecific antibodies are transforming relapsed disease

📍 Ann Arbor Staging System

Lymphoma staging describes how far the disease has spread from its site of origin. The Ann Arbor system (with Lugano modifications) is used for most lymphomas:

Stage I

Disease in a single lymph node region or a single extranodal organ

Stage II

Two or more lymph node regions on the same side of the diaphragm

Stage III

Lymph node involvement on both sides of the diaphragm

Stage IV

Widespread involvement of one or more extranodal organs (e.g., bone marrow, liver)

Suffix A = no B symptoms; suffix B = presence of fever, night sweats, or unexplained weight loss >10%. Suffix E = single extranodal site contiguous with a lymph node region.

🔬 Common Lymphoma Subtypes

Click a subtype to explore detailed information, treatment approaches, and research.

Hodgkin Lymphoma

Most Curable

Defined by Reed-Sternberg cells. Bimodal age distribution. Excellent cure rates with ABVD / BV-AVD.

→DLBCL

Diffuse Large B-Cell Lymphoma

Most Common NHL

Aggressive B-cell lymphoma. R-CHOP is standard. CAR T-cell therapies are approved for relapsed disease.

→FL

Follicular Lymphoma

Indolent

Slow-growing B-cell lymphoma with waxing/waning course. Watch-and-wait is standard for low-burden disease.

→MCL

Mantle Cell Lymphoma

t(11;14) Translocation

Broad clinical spectrum from indolent to aggressive. BTK inhibitors are a cornerstone of treatment.

→TCL

T-Cell Lymphomas

T-Cell Origin

Heterogeneous group (PTCL-NOS, AITL, ALCL). Generally poorer prognosis than B-cell NHLs; ALK+ ALCL is an exception.

→

💊 The Treatment Landscape

🧪

Chemoimmunotherapy

R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, prednisone) is the standard backbone for most aggressive B-cell lymphomas. Bendamustine-rituximab is used for many indolent and MCL patients.

🎯

Targeted Antibody Therapies

Anti-CD20 antibodies (rituximab, obinutuzumab) are foundational in B-cell lymphomas. Brentuximab vedotin (anti-CD30 ADC) is used in Hodgkin HL and ALCL. Polatuzumab vedotin (anti-CD79b ADC) enhances R-CHOP for high-risk DLBCL.

🧬

CAR T-Cell Therapy

CAR T-cell therapies (axi-cel, liso-cel, tisa-cel) are FDA-approved for relapsed/refractory DLBCL, FL (3rd line+), and MCL. They re-engineer a patient's T-cells to recognize and destroy CD19-expressing lymphoma cells.

⚡

Bispecific Antibodies

A rapidly emerging class engaging both CD20 (on lymphoma) and CD3 (on T-cells) simultaneously. Glofitamab, epcoritamab, and mosunetuzumab are approved for relapsed DLBCL/FL, offering an off-the-shelf alternative to CAR T.