The microscopic appearance and the stage of the lymphoma are the most important factors in determining both the prognosis and the appropriate therapy. Other factors affecting the prognosis for a particular person include age, general physical condition, the presence of "B" symptoms, abnormal laboratory tests, the presence of large masses and the number of extralymphatic sites.
With greater understanding of the biology of NHL, other factors have recently been recognized—biologic parameters such as determination of growth fraction or genetic changes—that can be related to the clinical outcome of the disease. It is expected that these will play a greater role in deciding on treatment in the future.
Low-Grade Although low-grade lymphomas grow slowly and respond readily to chemotherapy , they almost invariably return and are generally regarded as incurable cancers.
It is usual for the low-grade lymphomas to be widespread at the time of diagnosis, including involvement in the bone marrow . Despite this, the average survival of people with these lymphomas is 6 to 12 years.
The long-term outcome of the disease has not been favorably affected by the use of immediate chemotherapy in patients who have no symptoms, so close observation alone may be the initial therapy of choice, particularly in patients over age 60. Single agent or combination chemotherapy or radiation therapy may be required when the disease progresses or begins to cause symptoms.
