Non-Hodgkin Lymphoma Treatment | I D Cancer Center Lucknow
Overview
Non-Hodgkin Lymphoma (NHL) is a group of cancers that begin in the lymphatic system, affecting white blood cells called lymphocytes. NHL can involve lymph nodes, bone marrow, spleen, liver, stomach, skin, and even the brain.
There are over 60 subtypes of NHL, ranging from slow-growing (indolent) to fast-growing (aggressive) forms. With today’s medical advancements—PET-CT staging, immunotherapy, targeted therapy, modern chemotherapy, radiotherapy, and stem cell transplant—most patients experience excellent outcomes.
At I D Cancer Center, we offer comprehensive, individualized NHL care with state-of-the-art diagnostics and evidence-based treatment.
Non-Hodgkin Lymphoma (NHL) is a group of cancers that begin in the lymphatic system, affecting white blood cells called lymphocytes. NHL can involve lymph nodes, bone marrow, spleen, liver, stomach, skin, and even the brain.
There are over 60 subtypes of NHL, ranging from slow-growing (indolent) to fast-growing (aggressive) forms. With today’s medical advancements—PET-CT staging, immunotherapy, targeted therapy, modern chemotherapy, radiotherapy, and stem cell transplant—most patients experience excellent outcomes.
At I D Cancer Center, we offer comprehensive, individualized NHL care with state-of-the-art diagnostics and evidence-based treatment.
Common Types of Non-Hodgkin Lymphoma
B-Cell Lymphomas (most common)
Diffuse Large B-Cell Lymphoma (DLBCL) – aggressive but highly curable
Follicular Lymphoma – slow-growing
Mantle Cell Lymphoma
Marginal Zone / MALT Lymphoma
Burkitt Lymphoma
Primary Mediastinal B-Cell Lymphoma
Diffuse Large B-Cell Lymphoma (DLBCL) – aggressive but highly curable
Follicular Lymphoma – slow-growing
Mantle Cell Lymphoma
Marginal Zone / MALT Lymphoma
Burkitt Lymphoma
Primary Mediastinal B-Cell Lymphoma
T-Cell Lymphomas
Peripheral T-Cell Lymphoma
Anaplastic Large Cell Lymphoma (ALCL)
Cutaneous T-Cell Lymphoma (skin-involving)
Each subtype behaves differently and requires a tailored treatment plan.
Peripheral T-Cell Lymphoma
Anaplastic Large Cell Lymphoma (ALCL)
Cutaneous T-Cell Lymphoma (skin-involving)
Each subtype behaves differently and requires a tailored treatment plan.
Causes & Risk Factors
Although the exact cause is not always known, risk factors include:
Older age
Weakened immune system
Autoimmune disorders
Prior chemotherapy or radiation
Chronic infections (H. pylori, Hepatitis C, HIV, HTLV-1)
Family history
Exposure to pesticides or industrial chemicals
NHL is not contagious.
Although the exact cause is not always known, risk factors include:
Older age
Weakened immune system
Autoimmune disorders
Prior chemotherapy or radiation
Chronic infections (H. pylori, Hepatitis C, HIV, HTLV-1)
Family history
Exposure to pesticides or industrial chemicals
NHL is not contagious.
Symptoms of Non-Hodgkin Lymphoma
Symptoms often develop gradually.
Symptoms often develop gradually.
Common Signs
Painless swelling of lymph nodes (neck, armpit, groin)
Fever
Night sweats
Unexplained weight loss
Persistent fatigue
Loss of appetite
Cough, breathlessness or chest discomfort
Abdominal pain/fullness (from enlarged spleen)
Recurrent infections
Painless swelling of lymph nodes (neck, armpit, groin)
Fever
Night sweats
Unexplained weight loss
Persistent fatigue
Loss of appetite
Cough, breathlessness or chest discomfort
Abdominal pain/fullness (from enlarged spleen)
Recurrent infections
“B symptoms”
Fever
Night sweats
Weight loss
These indicate more active disease.
If symptoms persist for more than 2–3 weeks, professional evaluation is essential.
Fever
Night sweats
Weight loss
These indicate more active disease.
If symptoms persist for more than 2–3 weeks, professional evaluation is essential.
Diagnosis at I D Cancer Center
A correct diagnosis and subtype classification are critical.
A correct diagnosis and subtype classification are critical.
1. Clinical Evaluation
Complete physical examination
Symptom assessment
Complete physical examination
Symptom assessment
2. Blood Tests
CBC
LDH (marker of disease activity)
ESR
Viral markers (HIV, Hepatitis B & C)
CBC
LDH (marker of disease activity)
ESR
Viral markers (HIV, Hepatitis B & C)
3. Imaging
PET-CT Scan → Gold standard for staging NHL
CT scan
Ultrasound
PET-CT Scan → Gold standard for staging NHL
CT scan
Ultrasound
4. Lymph Node Biopsy
Excisional biopsy (preferred)
Core needle biopsy (selected cases)
Excisional biopsy (preferred)
Core needle biopsy (selected cases)
5. Immunohistochemistry (IHC)
Determines lymphoma subtype:
CD20
CD3
CD10
BCL-2, BCL-6
Ki-67 (proliferation index)
Determines lymphoma subtype:
CD20
CD3
CD10
BCL-2, BCL-6
Ki-67 (proliferation index)
6. Molecular Testing (if needed)
FISH (MYC, BCL-2, BCL-6 rearrangements)
NGS for genetic mutations
FISH (MYC, BCL-2, BCL-6 rearrangements)
NGS for genetic mutations
7. Bone Marrow Biopsy
For staging and treatment planning.
For staging and treatment planning.
Treatment Options
Treatment depends on subtype, stage, age, symptoms, and overall health.
Treatment depends on subtype, stage, age, symptoms, and overall health.
⭐ 1. Chemotherapy
Mainstay of treatment for many NHL types:
R-CHOP (most common)
R-EPOCH, Hyper-CVAD, ICE (aggressive cases)
Bendamustine-based regimens (indolent lymphomas)
Mainstay of treatment for many NHL types:
R-CHOP (most common)
R-EPOCH, Hyper-CVAD, ICE (aggressive cases)
Bendamustine-based regimens (indolent lymphomas)
⭐ 2. Targeted Therapy
Attacks cancer cells specifically, reducing side effects.
Rituximab (CD20-targeted)
Ibrutinib, Acalabrutinib (BTK inhibitors)
Lenalidomide
Venetoclax
Attacks cancer cells specifically, reducing side effects.
Rituximab (CD20-targeted)
Ibrutinib, Acalabrutinib (BTK inhibitors)
Lenalidomide
Venetoclax
⭐ 3. Immunotherapy
For relapsed/refractory disease:
Pembrolizumab
Nivolumab
CAR-T Cell Therapy (select cases)
For relapsed/refractory disease:
Pembrolizumab
Nivolumab
CAR-T Cell Therapy (select cases)
⭐ 4. Radiation Therapy
At I D Cancer Center, radiotherapy uses:
IMRT (Intensity-Modulated Radiotherapy)
IGRT (Image-Guided Radiotherapy)
VMAT (Volumetric Arc Therapy)
Used for:
Early-stage localized lymphoma
Residual lymph nodes after chemotherapy
Bulky disease
Symptom relief (pain, compression)
At I D Cancer Center, radiotherapy uses:
IMRT (Intensity-Modulated Radiotherapy)
IGRT (Image-Guided Radiotherapy)
VMAT (Volumetric Arc Therapy)
Used for:
Early-stage localized lymphoma
Residual lymph nodes after chemotherapy
Bulky disease
Symptom relief (pain, compression)
⭐ 5. Stem Cell Transplant
Recommended for:
Relapsed disease
High-risk aggressive NHL
Select slow-growing NHL cases
Includes autologous or allogeneic transplants.
Recommended for:
Relapsed disease
High-risk aggressive NHL
Select slow-growing NHL cases
Includes autologous or allogeneic transplants.
Living with NHL
We provide complete supportive care:
Nutritional and lifestyle counselling
Pain and symptom management
Psychosocial support
Regular PET-CT and laboratory follow-up
Infection prevention strategies
Rehabilitation and survivorship programs
Many patients return to a normal, healthy life after treatment.
We provide complete supportive care:
Nutritional and lifestyle counselling
Pain and symptom management
Psychosocial support
Regular PET-CT and laboratory follow-up
Infection prevention strategies
Rehabilitation and survivorship programs
Many patients return to a normal, healthy life after treatment.
