Management of non-Hodgkin's lymphomas

The non-Hodgkin's lymphomas (NHL) are a heterogenous group of disorders cha racterised by malignant proliferation of lymphoid cells. The cellular origi n is relatively well established with subtypes corresponding to the various stages of lymphocyte differentiation. The term encompasses a hotchpotch of conditions with very different morphological appearance, behaviour and cli nical outcome. NHL comprise 2.4% of all cancers, with incidence increasing with age. The commonest presentation is with progressive lymphadenopathy, t hough extranodal manifestations are present in a significant proportion. Th e clinical behaviour ranges from a benign, indolent course to rapidly progr essive disease; prognosis varies from weeks to many years. Treatment is cor respondingly diverse, from 'watchful waiting' to high-dose chemotherapy wit h bone marrow stem cell transplantation. Cure is possible in an increasing number of patients and much interest currently lies in identifying patients with high-risk disease necessitating the use of intensive treatment regime ns.