Diagnosis and treatment of non-Hodgkin's lymphoma of adults

The non-Hodgkin's lymphomas (NHL) represent a diverse group of neoplasms with many different clinical presentations, associated laboratory abnormalities, responsiveness to treatment, and clinical outcome. The cell of origin and stage of maturation arrest prior to uncontrolled proliferation are important to the understanding of this diversity (Table 47.1). In the USA, the incidence of NHL steadily increases from childhood through age 80 years; unlike Hodgkin's disease, no peak incidence exists for young adults. NHL is the fifth most common malignancy in men and women, respectively, and is among the most rapidly increasing malignancies [1]. They represent the seventh most common cause of death from cancer in the USA, with the age-adjusted incidence being about three times that of Hodgkin's disease [1]. The incidence of non-Hodgkin's lymphoma is twice as frequent among whites as blacks, and there is an almost 50 % increase in presentation in males compared with females. The reason for this gender and race predominance is unknown; however, it may reflect a different pattern of occupational exposure or a difference in the immune status of males compared with females. Links among agricultural work (organochlorine-based pesticides), wood products, and organic solvents have been established [2].