Non-Hodgkin's Lymphoma (NHL) is a cancer that originates from the lymphatic system, i.e., a part of the immune system. In this disease, the white blood cells called lymphocytes showcase an abnormal growth and quick spread across different parts of the body, which, in turn, forms tumors. NHL is classified into various sub-categories, depending upon the cell of origin like B-cell or T-cell & its characteristics. After the detection of the cell origin, the prediction for the necessity of early treatment, the type of treatment required, the response to treatment, & the prognosis are classified.

With the rising influx of patients with different categories of blood cancer, the leading biotechnological & pharmaceutical companies worldwide are actively working on developing novel drugs for more effective & safe treatment. Governments of various countries are massively spending on research & development activities associated with the treatment of NHL & other malignancies while focusing on expanding their respective healthcare facilities, research centers & labs, etc. Based on these aspects, a recent research study has cited around 7.6% CAGR for the Global Non-Hodgkin Lymphoma (NHL) Market during 2022-27, which would be dominated by North America, particularly the US, in terms of drug sales.

What Causes Non-Hodgkin Lymphoma?

As most cancers still need further research to tell their causes, it is pretty much the case with Non-Hodgkin Lymphoma too. However, there are a few medical conditions associated with an increased risk of developing the disease. Let us take a look at these signs in the list below:

• Disorders with the immune system, rheumatoid arthritis, systemic lupus erythematosus
• Inflammatory bowel disease, particularly Crohn’s disease, and its treatment
• Immune deficiencies inherited genetically
• Non-random chromosomal translocations & molecular rearrangements
• Occurrence of diseases like Celiac involving processing of components of gluten
• Psoriasis
• Syndromes like Klinefelter's syndrome, down syndrome
• Viruses like HIV, hepatitis virus, HTLV-1, SV-40, HHV-8, Epstein Barr virus 

Apart from these aspects, there are other possible causes for NHL, like:

• High or regular exposure to chemicals like insect & weed killers, chemicals used in farming, welding, & lumber
• Exposure to nuclear accidents, nuclear testing, or underground radiation leaks
• Treatment with immunosuppressant drugs to prevent organ transplantation rejection or treatment of inflammatory & autoimmune disorders
• Application of tumor necrosis factor agents for the treatment of psoriatic & rheumatoid arthritis & inflammatory bowel disease
• Any history of chemotherapy and/or radiation for the treatment of diagnosed cancer
• Use of medication called Dilantin (phenytoin) for the treatment of seizure disorders
• Excessive use of hair dyes like dark & permanent colors
• High levels of nitrates in drinking water
• High fat & meat intake 
• Excessive exposure to Ultraviolet light 
• Alcohol consumption

What is the Most-Effective Treatment for Non-Hodgkin Lymphoma?

Treatment of Non-Hodgkin Lymphoma depends on numerous factors like its type, stage, & symptoms. Chemotherapy, radiotherapy, immunotherapy, stem cell transplant, targeted therapy, and, in rare cases, surgery are different treatment options available for NHL. Rituximab + chemotherapy is the most common therapeutic prescribed, and radiation remains the primary treatment for NHL patients in the early stages. However, for advanced cases or recurrence, chemotherapy + immunotherapy, targeted therapy, and, in some cases, radiation therapy is prescribed. Let's have a look at some major categories of Non-Hodgkin Lymphoma & their treatment options:

-DLBCL (Diffuse Large B-cell Lymphoma): For the early-stage cases, 3 to 6 lines of R-CHOP regimen (rituximab, cyclophosphamide, hydroxydaunorubicin hydrochloride (doxorubicin hydrochloride), vincristine (Oncovin) and prednisone), combination chemotherapy, are followed, with or without radiation therapy to the affected lymph node. In later stages, the preferred treatment is six cycles of R-CHOP. Further, PET/CT scans are done to determine treatment response post 2-4 cycles. On the other hand, Refractory or relapsed DLBCL can be well-treated with a salvage regimen, followed by bone marrow transplant for eligible patients or Chimeric Antigen Receptor (CAR-T) cell therapy, effective immunotherapy with fewer side effects in which the patient's own T lymphocytes are altered genetically with a gene that encodes a CAR and hits the patient's cancer.

-FL (Follicular Lymphoma) has a good response rate to the treatment, but its cure is quite difficult, with high chances of relapse after several years. Radiotherapy is the preferred treatment for patients in stages I & II of FL., with chemotherapy + monoclonal antibody as the second option. However, monoclonal antibodies like Rituximab or Obinutuzumab alongside chemotherapy are preferred for patients with advanced FL

-Mantle cell lymphoma (MCL) involves challenging treatment, too, as patients usually receive the diagnosis in advanced stages, where the disease has spread throughout the body. It is treated majorly with aggressive chemotherapy and rituximab, but only in eligible patients. Below cited are various options for MCL treatment:

• Rituximab (Rituxan) + other chemotherapy drugs for the treatment of different lymphoid cell cancers
• Newer chemotherapy drugs like Bortezomib (Velcade)
• Autologous stem cell transplantation and R-hyper-CVAD (rituximab and Cyclophosphamide, Vincristine, Adriamycin, & Dexamethasone), i.e., aggressive chemotherapy, along with R-DHAP (Rituximab and Dexamethasone, Cytarabine, & Cisplatin) chemotherapy for refractory MCL

Takeaway

As the prevalence of cancer, including Non-Hodgkin Lymphoma, is becoming highly common among people across different countries worldwide, governments of various countries worldwide are spreading awareness about the availability of its effective diagnosis & treatments. In fact, many countries are conducting rigorous research & development activities to bring innovations to existing medications and introduce new drugs for the same. Hence, it is likely that the influx of patients seeking treatment would increase in the future and play a prominent role in augmenting the growth of the Global Non-Hodgkin Lymphoma (NHL) Market in the years to come.