Prognosis

Prognosis depends on the type of lymphoma, stage of disease, treatment, and comorbidities.

Worse prognosis is indicated by the following:[116][118][119]

  • Older age (>60 years)

  • Advanced-stage disease

  • Elevated serum lactate dehydrogenase (LDH) level

  • B symptoms (fever, weight loss, night sweats)

  • Lymphadenopathy

  • Organomegaly

  • Extranodal involvement

  • Poor Eastern Cooperative Oncology Group (ECOG) performance status.

Chemotherapy (e.g., R-CHOP) may be curative in a sizeable proportion of patients with aggressive lymphomas.[203] Indolent lymphomas are treatable, but patients may be subject to repeated relapses with recurrent need for treatment.[204] 

Prognosis by NHL subtype

Diffuse large B-cell lymphoma (DLBCL)

Five-year survival rates (stage at diagnosis, National Cancer Institute Surveillance, Epidemiology, and End Results Program data 2015-2021):[205]

  • Stage I: 80.0%

  • Stage II: 75.8%

  • Stage III: 67.3%

  • Stage IV: 55.8%

Follicular lymphoma

Five-year survival rates (stage at diagnosis, National Cancer Institute Surveillance, Epidemiology, and End Results Program data 2015- 2021):[206]

  • Stage I: 97.3%

  • Stage II: 90.5%

  • Stage III: 88.7%

  • Stage IV: 83.1%

Primary CNS

  • Methotrexate-based chemotherapy with whole-brain radiotherapy results in 2-year survival of 40% to 70%.[207]

Primary effusion lymphoma (PEL)

  • Median survival is 6 months.[208]

Burkitt's lymphoma

  • Overall survival is approximately 64% at 2 years and approximately 61% at 5 years (based on National Cancer Institute Surveillance, Epidemiology, and End Results Program data 2000-2019).[209]

Mantle cell lymphoma

  • Five-year overall survival is approximately 57% (based on National Cancer Institute Surveillance, Epidemiology, and End Results Program data 2015-2019).[210]

Subcutaneous panniculitis-like peripheral T-cell lymphoma

  • Has a very aggressive course, with poor prognosis.

Systemic anaplastic large cell lymphoma (ALCL)

  • ALK-negative ALCL has an unfavourable prognosis.[211] 

  • Data extracted from the Surveillance, Epidemiology and End Result (SEER) database suggest median survival of 118 months among patients with ALK-positive ALCL.[212]​ 

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

  • Has a slow (indolent) disease course, with excellent prognosis following surgery in patients with localised disease (i.e., confined to the fibrous scar capsule) with no mass.[213]

  • Patients presenting with a mass or advanced-stage disease have a poorer prognosis.[213][214]

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