Cancers that begin in cells of the lymph system are referred to as malignant lymphomas. Lymphomas range from aggressive to slow growing or indolent and can be effectively treated. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes and circulating white blood cells called lymphocytes. Lymphocytes and the lymph system are part of the immune system that protects the body from disease and infection. Cancers of the lymph system are referred to as Hodgkin lymphoma or non-Hodgkin lymphoma (NHL).

The majority of lymphomas can be effectively treated and optimal treatment of lymphoma may consist of chemotherapy, radiation, stem cell transplant, targeted therapies or radio-immunotherapy (RIT) used alone or in combination. The type of treatment used is determined by the type (histologic diagnosis) and stage of the lymphoma.

Lymphoma Classification

In order to understand the prognosis and optimal treatment of NHL, “click” the NHL of interest below.

Revised European American Lymphoma (Real) Classification

  1. B-Cell Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia
  2. Lymphoplasmacytic Lymphoma
  3. Mantle Cell Lymphoma
  4. Follicle Center Lymphomas, Follicular
  5. Marginal Zone B-Cell Lymphoma
  6. MALToma
  7. Diffuse Large B-Cell Lymphoma
  8. Burkitt’s Lymphoma
  9. Burkitt’s Like Lymphoma
  10. Precursor B or T-Cell Lymphoblastic Lymphoma/Leukemia

International Working Formulation Classification Of Non-Hodgkin Lymphoma

High Grade:

  1. Large Cell Immunoblastic
  2. Lymphoblastic Lymphoma
  3. Small Noncleaved cell, Burkitt’s

Intermediate Grade:

  1. Diffuse Large Cell
  2. Follicular Large Cell
  3. Diffuse Small Cleaved Cell
  4. Diffuse Mixed Small and Large cell

Low Grade:

  1. Small Lymphocytic/Chronic Lymphocytic Leukemia
  2. Follicular Small Cleaved Cell
  3. Follicular Mixed Small and Large Cell

Understanding Classification of Non-Hodgkin Lymphomas

The purpose of further classifying non-Hodgkin lymphomas into specific categories is to describe the individual behavior and develop appropriate treatment strategies for each type of lymphoma. Non-Hodgkin lymphomas have been classified by several different systems over the past 30 years. The most common system used in the 1980?s-1990?s was the International Working Formulation (IWF). The IWF divided non-Hodgkin lymphomas into 3 grades based on the lymphoma’s appearance under a microscope. Since the IWF was utilized, a great deal of additional work has been performed that further classifies non-Hodgkin lymphomas into individual cancers, each with their own specific features and behavior. This newer system is called the Revised European American Lymphoma (REAL) classification and has been recommended for use by all doctors. Unfortunately, it will take several years for all doctors and the results of clinical trials to refer to the REAL system.