Non-Hodgkin's Lymphoma - Outlook

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Risk Factors for Central Nervous System Involvement

Lymphoma can spread to the central nervous system or it can appear there first, which is referred to as primary CNS lymphomas (PCNSL). It is a very serious event, particularly if it occurs at relapse.

Risk Factors for CNS Involvement After a Diagnosis of NHL. According to a 2002 study, the risk for CNS involvement in low-grade NHL is about 2.8%. Among patients with high-grade NHL, those with lymphoblastic and Burkitt's lymphoma are at high risk (nearly 25%) for recurrence in the central nervous system. For other patients with high-grade NHL, the 5-year risk was slightly over 5%, although having other factors increased this danger.

Risk Factors of Primary CNS Lymphomas. PCNSL used to account for only about 2% of lymphomas, but the incidence is on the rise in all age groups and in both. The reason for the increase is not known.

Long-Term Complications of Treatments

Medical Problems. The radiation and chemotherapies used in treating NHL can have long-term effects on many organs in the body and can increase the risk for serious illnesses, including heart disease and certain cancers.

Negative Emotional Problems. Depression and anxiety are common in survivors, particularly those who suffer additional medical conditions. Many patients also suffer from fatigue and aches and pains, called somatic symptoms, which have no apparent physical basis. In one study, such symptoms were more highly associated with intensive chemotherapy. Women and people in lower social and economic groups are at higher risk for depression and somatic symptoms -- just as they are in the general population.

Review Date: 01/17/2007
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.