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Statistics and outlook for non Hodgkin lymphoma

Men and women discussing non Hodgkin's lymphoma

This page is about statistics and what they can tell us about the outlook for people with non Hodgkin lymphoma. You can find the following information

 

A quick guide to what's on this page

Statistics and outlook for non Hodgkin lymphoma

Outlook means your chances of getting better. Your doctor may call this your prognosis. The likely outcome of non Hodgkin lymphoma depends partly on how advanced the cancer is when it is diagnosed (the stage). But the type of lymphoma and whether your lymphoma is low grade (indolent) or high grade (aggressive) is also very important.

The statistics we use are taken from a variety of sources, including the opinions and experience of the experts who check every section of Cancer Research UK's patient information. They are intended as a general guide only. For the more complete picture in your case, you’d have to speak to your own specialist.

The information further down the page is quite detailed. We include statistics because people ask for them, but not everyone wants to read this type of information. Remember that you can skip this page if you don't want to read it. You can always come back to it.

How reliable are cancer statistics?

No statistics can tell you what will happen to you. Your cancer is unique. Many individual factors affect your treatment and your outlook. Outcomes for patients with most types of lymphoma have improved steadily over time. Because of the way they are collected statistics tend to show these improvements some years later.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating NHL section.

 

 

About the information on this page

This page contains quite detailed information about the survival rates for different types and stages of non Hodgkin lymphoma. We have included it because many people have asked us for this. But not everyone who is diagnosed with a cancer wants to read this type of information. If you are not sure whether you want to know at the moment or not, then perhaps you might like to skip this page for now. You can always come back to it.

Please note that there are no UK statistics available for different stages of lymphoma, or for treatments that people may have had. The statistics we present here are pulled together from a variety of different sources, including the opinions and experience of the experts that check each section of Cancer Research UK's patient information. We give statistics because people ask us for them. But they are only intended as a general guide and cannot be regarded as any more than that.

 

Cancer statistics in general

There is a section explaining more about the different types of cancer statistics in the section about incidence, mortality and survival. Unless you are very familiar with medical statistics, it might help to read this before you read the statistics below.

Remember that 5 year survival and 10 year survival are terms that doctors use. This doesn't mean that you will only live 5 or 10 years. The 10 year survival figure gives the number of people in research who are still alive 10 years after their diagnosis. Doctors follow what happens to people for 5 or 10 years after treatment in any research study. They do not like to say these people are cured because of the chance that the cancer will come back. With low grade lymphoma some people will still have the disease after 5 or 10 years but it can be kept under control with treatment. So, doctors usually talk about 5 year and 10 year survival instead of cure.

 

Overall outcome

Of all those with non Hodgkin lymphoma, about 80 out of every 100 people (80%) will live for at least a year after they are diagnosed. About 69 out of every 100 people (69%) will live for at least 5 years. And about 63 out of every 100 people (63%) will live for at least 10 years.  

The outcome of non Hodgkin lymphoma depends on the type of lymphoma and in particular whether your lymphoma is low grade (indolent) or high grade (aggressive). But as with many other types of cancer, the outcome also depends on how advanced it is when it is diagnosed. In other words, the stage of your cancer.

 

Outlook for low grade lymphomas

Here we give information about the outlook for

Follicular lymphoma

The most common type of low grade (indolent) lymphoma is follicular lymphoma. About 30 out of every 100 of all non Hodgkin lymphomas diagnosed (30%) are this type. Low grade lymphomas can be difficult to clear completely. But they are often kept under control for several years.

If your follicular lymphoma is diagnosed at an early stage, when it is localised, you may be cured with radiotherapy. Of every 100 people diagnosed with stage 1 or 2 follicular lymphoma, between 60 and 80 (60 to 80%) are alive more than 10 years later.

There is a scale that doctors use to help them to tell in advance who may be helped by particular types of chemotherapy. It is called the Follicular Lymphoma International Prognostic Index (FLIPI). It has identified 5 factors that doctors can use to try and tell who will do well after treatment.  These 5 factors are

  • Being older than 60 years
  • Having stage 3 or 4 follicular lymphoma
  • Having a low haemoglobin level
  • Having more than 4 areas of lymph nodes affected with lymphoma
  • A higher than normal blood level of an enzyme called  LDH (serum lactate dehydrogenase)

In people with none or one of these factors about 91 out of every 100 people (91%) live for more than 5 years after they are diagnosed. And 71 out of every 100 people (71%) live for more than 10 years.

In people with 2 of these factors about 78 out of every 100 people (78%) live for more than 5 years after diagnosis. And 51 out of every 100 (51%) live for more than 10 years.

In people with 3 or more of these factors about 53 out of every 100 people (53%) live for more than 5 years after they are diagnosed. And 36 out of every 100 (36%) live for more than 10 years.

It is important to remember that these numbers are  averages. This means that they are only a guide and can't tell you what will happen to you.

With stage 3 or 4 follicular lymphoma, some people live free of symptoms for several years before they need to have treatment. Between 40 and 55 out of every 100 people (40% to 55%) live for at least 10 years.

MALT lymphoma

MALT is another type of low grade lymphoma. Between 7 and 8 of every 100 lymphomas diagnosed (7 to 8%) are MALT lymphomas. But they are worth mentioning separately because their outlook is different from other types of low grade lymphoma. In people diagnosed with MALT lymphomas of the stomach, about 90 out of every 100 people (90%) will live for at least 5 years. MALT lymphomas outside the digestive system also have a good outlook.

 

Outlook for high grade lymphomas

High grade (aggressive) lymphomas generally need more intensive treatment than the low grade types. But they often respond well to treatment. Many people are cured. The most common type of high grade lymphoma is diffuse large B cell lymphoma. It is called diffuse because the cells look spread out when seen under a microscope. About 31 in 100 of all lymphomas diagnosed (31%) are this type.

About 6 out of 10 people (60%) are cured, but it is difficult to be exact about outcome for individual people. There are many different types of high grade lymphoma and each behaves quite differently.

 

Other factors

Whether you are likely to be cured depends on a number of different factors. Doctors identified these factors and grouped them together to make a prognostic index for people with diffuse large B cell lymphoma (a high grade lymphoma). A prognostic index is a way of trying to decide who has a greater risk of their lymphoma coming back after treatment. If high grade NHL comes back (relapses), it is less likely to be curable. 

Age is one of the most important factors that affects outcomes. As you will see, you will need to talk this over with your doctor to get all the facts you need. This prognostic index was created before doctors used rituximab to treat lymphoma. Rituximab may lower the risk of lymphoma coming back. So this may affect the prognostic index in the future.

To work out the prognostic index, you score one point for each of the following:

  • Aged over 60
  • Stage 3 or 4 lymphoma at diagnosis
  • Raised lactate dehydrogenase levels in your blood
  • Performance status of more than 2 (see below)
  • NHL in more than one site outside your lymphatic system (extranodal disease), for example, in your bones

Performance status is a scoring system that describes how well you are and how much you can look after yourself. 0 means you are fully active and well. If you need to stay in bed or a chair for more than half the day and need a lot of help to look after yourself, your performance status will be more than 2.

If your score from the prognostic index is 0 or 1, then you are more likely to respond well to treatment, and your lymphoma is unlikely to come back. If you scored 2, then you are at moderately low risk of your lymphoma coming back.

A score of 3 means you have a moderately high risk of the lymphoma coming back. If you scored 4 or 5, then unfortunately you are at a higher than average risk of not responding to treatment, or of having your lymphoma come back after treatment.

Remember that scoring systems can only ever provide a guess based on what has happened to patients in the past. In other words, you can score highly and still respond well to treatment. It can only be used as a guide. And this scale is only for people with diffuse large B cell lymphomas not low grade lymphomas.

 

How reliable are cancer statistics?

No statistics can tell you what will happen to you. Your cancer is unique. The same type of cancer can develop at different rates in different people.

The statistics are not detailed enough to tell you about the different treatments people may have had. And how that treatment may have affected their prognosis. Some treatments may help people to live longer as well as relieving symptoms. There are many individual factors that will affect your treatment and prognosis. 

 

Clinical trials

Clinical trials have made a great difference to the treatment and prognosis of both low grade and high grade lymphomas. Trials of combination chemotherapy have improved response rates for high grade lymphomas. Now, trials are investigating combining these standard treatments with newer treatments such as biological therapies. New treatments such as monoclonal antibody therapy (a type of biological therapy) are increasing the survival time for low grade lymphomas.

If you are interested in taking part in a clinical trial, go to our clinical trials database and choose 'lymphoma' from the dropdown menu. If you would like to know more about clinical trials, look at our about clinical trials section.

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Updated: 30 April 2014