📌 Definition
Non-Hodgkin’s Lymphoma is a diverse group of blood cancers originating in lymphocytes, characterized by the absence of Reed-Sternberg cells and often presenting with widespread lymph node involvement.
🧠 Anatomy & Physiology: Lymphatic System
- Lymphocytes: B and T cells central to immune response
- Lymph nodes: Primary site of tumor development
- Other sites: Spleen, thymus, tonsils, GI tract, skin, CNS
- Widespread: May involve multiple organ systems at diagnosis
⚠️ Etiology: Causes & Risk Factors
- Immunosuppression (e.g., post-transplant, HIV)
- Infections: EBV, H. pylori, Hepatitis C
- Autoimmune diseases (e.g., SLE, Sjögren’s)
- Exposure to chemicals (herbicides, pesticides)
- Older age, male sex
🩺 Symptomatology
- Painless, enlarged lymph nodes (neck, axilla, groin)
- Fever, night sweats, weight loss (B symptoms)
- Abdominal fullness, early satiety (splenomegaly)
- Chest pain, cough (mediastinal mass)
- Fatigue, anemia, infections (bone marrow involvement)
🔁 Pathophysiology (Simplified)
- Genetic or environmental trigger → mutation in lymphocyte DNA
- Uncontrolled proliferation of B or T cells
- Infiltration of lymphatic & extranodal tissue
- Immune dysfunction → increased infection risk
🧪 Medical Management
🔬 Labs & Diagnostics
- Lymph node biopsy – confirms NHL, classifies subtype
- PET/CT scan – evaluates spread/staging
- Bone marrow biopsy – detects infiltration
- LDH – marker of tumor burden
💊 Medications
- CHOP regimen: Cyclophosphamide, Doxorubicin, Vincristine, Prednisone
- Rituximab – monoclonal antibody for B-cell NHL
- Targeted and immunotherapies for aggressive or refractory types
🛠️ Treatments
- Chemotherapy – mainstay for most subtypes
- Radiation – for localized disease
- Stem cell transplant – for relapsed/resistant NHL
- CAR T-cell therapy – for specific aggressive forms
🧑⚕️ Nursing Management: 5 Key Interventions
- Monitor for neutropenia and prevent infection
- Manage chemo side effects (e.g., nausea, mucositis)
- Promote energy conservation and adequate nutrition
- Provide emotional and psychosocial support
- Educate on signs of relapse and follow-up care
🩹 Priority Nursing Diagnoses
- Risk for infection related to immunosuppression
- Imbalanced nutrition: Less than body requirements
- Fatigue related to disease and treatment
- Disturbed body image
- Anxiety related to diagnosis and prognosis
📉 Prognosis
- Indolent type: Slow progression, median survival 10+ years
- Aggressive type: Curable with treatment, 60–80% remission
- Refractory type: Requires advanced therapies (CAR T, SCT)
Note: Prognosis depends on subtype, stage, and response to treatment.
