Statistics and outlook for non Hodgkin's lymphoma

• A quick guide to what's on this page
• What you need to know about the information on this page
• Cancer statistics in general
• Outcome overall for NHL, by stage and type
• Outlook for low grade lymphomas
• Outlook for high grade lymphomas
• Factors that may affect outcome
• How reliable are cancer statistics?
• Clinical trials

This page contains quite detailed information about the survival rates of different types and stages of non Hodgkin’s lymphoma. We have included it because many people have asked us for this. But not everyone who is diagnosed with a cancer wants to read this type of information. If you are not sure whether you want to know at the moment or not, then perhaps you might like to skip this page for now. You can always come back to it.

Please note: There are no national statistics available for different stages of cancer, or for treatments that people may have had. The statistics we present here are pulled together from a variety of different sources, including the opinions and experience of the experts that check each section of CancerHelp UK. We give statistics because people ask us for them. But they are only intended as a general guide and cannot be regarded as any more than that.

There is a section explaining more about the different types of cancer statistics in the CancerHelp UK section on incidence, mortality and survival. Unless you are very familiar with medical statistics, it might help to read this before you read the statistics below.

Remember - ‘5 year survival' and '10 year survival’ are terms that doctors use. This doesn't mean that you will only live 5 or 10 years. The 10 year survival figure gives the proportion of people in research studies who are still alive 10 years after their diagnosis. Doctors follow what happens to people for 5 or 10 years after treatment in any research study. They do not like to say these people are cured because of the chance that the cancer will come back. With low grade lymphoma some people will still have the disease after 5 or 10 years but it can be kept under control with treatment. So, doctors talk about ‘5 year' and '10 year survival’ instead of cure.

If all types of non Hodgkin's lymphoma are included, 51 out of every 100 people (51%) diagnosed in England and Wales will live for at least 5 years. About 45 out of every 100 (45%) diagnosed will live for at least 10 years. But there are many different types of lymphoma, and the prognosis varies a lot between them.

As with many other types of cancer, the outcome of non Hodgkin’s lymphoma depends partly on how advanced it is when it is diagnosed. In other words, the stage of your cancer. But the type of lymphoma and whether your lymphoma is low or high grade is also very important.

Here we give information about

• Follicular B cell lymphoma
• MALT lymphoma

Follicular B cell lymphoma

The most common type of low grade lymphoma is follicular B cell lymphoma. About 3 in 10 (30%) of all non Hodgkin's lymphomas diagnosed are this type. Low grade lymphomas can be difficult to get rid of altogether. But they are often kept under control for several years at least.

If you have follicular lymphoma diagnosed at an early stage, when it is localised, it can usually be cured with radiotherapy. Of every 100 people diagnosed with stage 1 or 2 follicular lymphoma, between 60 and 80 (60 to 80%) are alive and well 10 years later, with no sign of their lymphoma.

There is a scale that doctors use to help them to tell in advance who may be helped by particular types of chemotherapy. It is called the Follicular Lymphoma International Prognostic Index (FLIPI). It has identified 5 factors that doctors can use to try and tell who will do well after treatment (your prognosis).

• Being older than 60 years
• Having stage 3 or 4 follicular lymphoma
• Low haemoglobin level
• More than 4 areas of lymph nodes with lymphoma ('involved' lymph nodes)
• Serum lactate dehydrogenase level greater than the upper limit of normal

In people with none or one of these factors, on average, 91 out of 100 people (91%) live for more than 5 years after they are diagnosed, and 71 out of 100 people (71%) live for more than 10 years

In people with 2 of these factors, on average, 78 out of 100 people (78%) live for more than 5 years after diagnosis, and 51 out of 100 (51%) live for more than 10 years

In people with 3 or more of these factors, on average, about 53 out of 100 people (53%) live for more than 5 years after they are diagnosed, and 36 out of 100 (36%) live for more than 10 years

It is important to remember that these numbers represent averages. This means that they are only a guide and can't tell you what will happen to you.

With stage 3 or 4 follicular lymphoma, some people live for several years with no symptoms from their disease, before they need to have treatment. Between 40 and 55 out of 100 people (40% to 55%) live for at least 10 years.

MALT lymphoma

This is another type of low grade lymphoma. Only about 7 to 8 in 100 lymphomas (7-8%) are MALT lymphomas. But they are worth mentioning separately because their outlook is different from other types of low grade lymphoma.

In people diagnosed with MALT lymphomas of the stomach, about 90 out of 100 people (90%) will live for at least 5 years. MALT lymphomas outside the digestive system also have a good outlook.

These lymphomas generally need more intensive treatment than the low grade types. But they often respond well to treatment. Many people are cured. The most common type of high grade lymphoma is diffuse large B cell lymphoma. About 31 in 100 of all lymphomas diagnosed (31%) are this type.

It is difficult to be specific about likely outcome, as there are so many different types of high grade lymphoma. And they do not all behave the same way. Generally speaking, about 6 out of 10 people (60%) are cured.

Whether you are likely to be cured depends on a number of different factors. Doctors identified these factors and grouped them together to make a 'prognostic index' for people with diffuse large B cell lymphoma (a high grade lymphoma). This is a way of trying to decide who has a greater risk of their lymphoma coming back after treatment. If high grade NHL comes back (relapses), it is less likely to be curable. Age is one of the most important factors. As you will see, you will need to talk this over with your doctor to get all the facts you need. This prognostic index was created before doctors used rituximab to treat lymphoma. Rituximab may lower the risk of lymphoma coming back. So this may affect the prognostic index in the future.

To work out the prognostic index, you score one point for each of the following:

• Aged over 60
• Stage 3 or 4 lymphoma at diagnosis
• Raised lactate dehydrogenase levels in your blood
• Performance status of more than 2 (see below)
• NHL in more than one site outside your lymphatic system (extranodal disease), for example, in your bones

Performance status is a scoring system that describes how well you are and how much you can look after yourself. 0 means you are fully active and well. If you need to stay in bed or a chair for more than half the day, and need quite a lot of help to look after yourself, your performance status will be more than 2.

If your score on this scale is 0 or 1, then you are likely to respond well to treatment, and your lymphoma is unlikely to come back. If you scored 2, then you are at moderately low risk of your lymphoma coming back.

A score of 3 means you have a moderately high risk of the lymphoma coming back. If you scored 4 or 5, then unfortunately you are at a higher than average risk of not responding to treatment, or of having your lymphoma come back after treatment.

Remember - scoring systems such as this can only ever provide a ‘rule of thumb’. In other words, you can score highly and still respond well to treatment. It is a guideline, not an accurate prediction. And remember this scale is for people with diffuse large B cell lymphomas not low grade lymphomas.

No statistics can tell you what will happen to you. Your cancer is unique. The same type of cancer can develop at different rates in different people.

The statistics are not detailed enough to tell you about the different treatments people may have had. And how that treatment may have affected their prognosis. Some treatments may help people to live longer as well as relieving symptoms. There are many individual factors that will affect your treatment and prognosis. If you are fit enough to have treatment, you are likely to do better than average, particularly if your cancer is more advanced.

Clinical trials have made a great difference to the treatment and prognosis of both low grade and high grade lymphomas. Trials of combination chemotherapy have improved response rates for high grade lymphomas. Now, trials are investigating combining these standard treatments with newer treatments such as biological therapies. New treatments such as monoclonal antibody therapy (a type of biological therapy) are increasing the survival time for low grade lymphomas.

If you are interested in taking part in a clinical trial, go to our clinical trials database and choose lymphoma from the drop down menu. If you would like to know more about clinical trials, look at our about clinical trials section.