Staging and grading of Non-Hodgkin lymphoma (NHL)
Knowing the extent of the lymphoma helps your doctor plan the right treatment. This is called staging. Lymphomas are also often grouped as either low-grade or high-grade.
The stage describes how many areas of the body are affected by lymphoma and where these areas are. This information helps doctors plan the right treatment for you.
The stage of a lymphoma is usually described using numbers from 1 to 4.
There are 2 or more areas of lymphoma on the same side of the diaphragm (the sheet of muscle underneath the lungs).
There are areas of lymphoma above and below the diaphragm.
The lymphoma is more widespread and may also affect organs such as the bone marrow, liver or lungs.
Stages 1 and 2 are also called early-stage, limited or localised lymphoma. Stages 3 and 4 are also called advanced lymphoma.
If you have any B symptoms, the letter B is added after the stage number, for example stage 1B. The B symptoms are:
- heavy drenching night sweats
- unexplained high temperatures
- unexplained weight loss.
If you do not have any of these symptoms, the letter A is used instead, for example stage 1A.
Sometimes lymphoma is found in parts of the body outside the lymph nodes. This is called extranodal lymphoma.
It is described by adding the letter E (for extranodal) after the stage number, for example 1E.
The staging of extranodal lymphoma depends on whether the lymphoma:
- started in an organ outside the lymph nodes - this is called primary extranodal NHL
- started in the lymph nodes and then spread somewhere else.
If you have extranodal lymphoma, your doctor can explain to you how this affects the stage.
Lymphomas are also often grouped as either low-grade or high-grade.
Low-grade lymphomas (sometimes called indolent)
High-grade lymphomas sometimes called aggressive
Below is a sample of the sources used in our non-Hodgkin lymphoma (NHL) information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
National Institute for Health and Care Excellence (NICE). Guideline NG46. Haematological cancers: improving outcomes. 2016.
National Institute for Health and Care Excellence (NICE). Guideline NG52. Non-Hodgkin’s lymphoma: diagnosis and management. 2016.
Treleaven, et al. Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force. British Journal of Haematology. 2011.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Anne Parker, Consultant Haematologist; and Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.
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