Staging non-Hodgkin lymphoma allows doctors and cancer researchers to estimate how far the disease has spread. The modern non-Hodgkin lymphoma (NHL) staging system is identified in adults using the Lugano classification. It is based on the old Ann Arbor system. The different stages of terminal disease are defined with Roman numerals I through IV.

While the lymphatic system is identified by an addition (E), stage I or II lymphoma (collectively known as limited stage) affects external organs called extranodal organs.

Stage I

• The lymphoma is a single lymph node area or lymphatic organ, such as the tonsils (I).
• The lymphoma occurs only in the area ofa single organ outside the lymphatic system (IE).

Stage II

• The lymphoma occurs in two or more groups of lymph nodes on the same side, above or below the thick band of muscle that divides the abdomen or chest, called the diaphragm.
• The lymphoma occurs in a specific group of lymph nodes that are also in the area of nearby organs (IIE). It may affect other lymph node groups on the same side of the diaphragm.

Stage III

Stage III non-Hodgkin lymphoma is identified based on either disease.

• The lymphoma develops in the lymph node areas on either side of the diaphragm.
• The lymphoma develops in the lymph nodes above the diaphragm as well as in the spleen.

Stage IV

In stage IV non-Hodgkin lymphoma, the lymphoma has spread extensively to at least one external organ, such as the bone marrow, liver, and lungs.

Non-Hodgkin lymphoma – Treatment

The dosage and frequency of treatment for non-Hodgkin lymphoma varies by stage and depends on the extent of the disease. Four main techniques are used to treat non-Hodgkin lymphoma. These four treatments are chemotherapy, drug therapy, radiation therapy, and stem cell transplantation.

Each technique is summarized below:

Chemotherapy

Chemotherapy is a very broad cancer treatment method that uses one or more cancer drugs called chemotherapeutic drugs. Therefore, it is also used in various cases of non-Hodgkin lymphoma. It is also known as chemo, CTx, and CTX. Chemotherapy is used to treat cancer for a variety of purposes, from prolonging life, relieving symptoms, to for curative purposes.

Radiation therapy

Radiation therapy, also known as RT, XRT, and RTx, uses ionizing radiation as part of the treatment of non-Hodgkin lymphoma. It helps kill and control malignant cells (cancer cells). It is also used as part of adjuvant therapy and to prevent tumor recurrence after tumor removal surgery. It works synergistically with chemotherapy, i.e., h. It can be used before, after, or even during chemotherapy for various types of cancer, such as non-Hodgkin lymphoma.

Stem cell transplant

Stem cell transplants are used to treat leukemia, multiple myeloma, and other types of cancer, and to treat certain types of lymphoma, as well as non-cancerous blood disorders. Stem cells are actually undifferentiated cells of multicellular organisms, such as humans, that are able to produce the cells the body needs. In the past, stem cells were extracted from the bone marrow to treat cancer and other diseases. Today, stem cells are extracted from the blood for treatment and research.

There are different types of stem cell transplants used to treat non-Hodgkin lymphoma. Many of these are currently being studied, such as cord blood transplants, parent-child transplants, and haplotype mismatch transplants. There are two main types used for lymphoma:

• Autotransplant (autologous transplant) – This type of stem cell transplant is also called high-dose chemotherapy combined with autologous stem cell rescue. During the transplant, the patient is injected with their own stem cells. The stem cells are removed from the blood and frozen for later use.
• ALLO transplant (allogeneic transplant) – Unlike AUTO transplant, ALLO transplant involves taking stem cells from another person. To do this, the donor and recipient's bone marrow must be similar. The most important factor is the HLA value (human leukocyte antigen). The best donor is the one whose HLA value is most similar to the recipient's. There are two main types of ALLO transplants: Ablative therapy uses high doses of chemotherapy, while reduced intensity uses a gentler dose of chemotherapy.

Medications

The main drug treatments for non-Hodgkin lymphoma are:

• Chemotherapy – It is one of the most effective treatments for non-Hodgkin lymphoma. It helps kill cells that grow or multiply very quickly.
• Bone marrow stimulants – Used only in certain types of cancer, it helps the patient produce new blood cells.
• Steroids – Usually used to reduce inflammation and promote tissue growth and repair. Steroids can change or mimic the effects of hormones.