Recent advances in the management of non-Hodgkin's lymphomas

The non-Hodgkin's lymphomas are a diverse group of diseases with distinctive natural histories and responsiveness to therapy. Each of these diseases represents the arrest and proliferation of malignant lymphocytes at a particular stage of normal lymphocyte differentiation. Cytogenetic and gene rearrangement studies have established the clonal nature of these disorders. The majority of the non-Hodgkin's lymphomas that occur in adults are of B cell origin. Exceptions to this are lymphoblastic lymphoma, mycosis fungoides, Sézary syndrome, and HTLV-1 associated leukemia--lymphomas that are diseases of T cell origin. As a group, the non-Hodgkin's lymphomas are diseases that are very responsive to radiation therapy and chemotherapy. There are major differences, however, in the durability of these responses. From a clinical standpoint, the non-Hodgkin's lymphomas may be divided into those that are indolent and those that are aggressive in their clinical behavior. Ironically, the aggressive non-Hodgkin's lymphomas are frequently curable, while the indolent non-Hodgkin's lymphomas are presently incurable in the majority of cases.