A Snapshot of Lymphoma

Incidence and Mortality

Lymphoma, including Hodgkin lymphoma and non-Hodgkin lymphoma(NHL), is the most common blood cancer in the United States and is estimated to represent approximately 5 percent of all new cancers diagnosed in the United States in 2014. Nearly 71,000 new cases of NHL and nearly 9,200 new cases of Hodgkin lymphoma are estimated for 2014.

Because of improvements in treatment, the mortality rate for Hodgkin lymphoma has decreased by nearly 70 percent since 1975, even though the incidence rate has remained relatively steady over the same period. Incidence rates for Hodgkin lymphoma are highest for whites and African Americans; mortality rates are highest for whites, Hispanics, and African Americans.

NHL incidence has been increasing since 1975, although the rate of increase has slowed in the past two decades. NHL mortality has declined since 1997. Incidence and mortality for NHL are higher for whites than for African Americans or other racial/ethnic groups in the United States.

Risk factors for both Hodgkin lymphoma and NHL include being male, having a weakened immune system, or being infected with human immunodeficiency virus (HIV) or Epstein-Barr virus. Infection withHelicobacter pylori or human T-cell leukemia/lymphoma virus type 1 (HTLV-1) increases the risk for certain types of NHL. The risk of NHL increases with age, whereas the risk of Hodgkin lymphoma is higher in both early adulthood and later life. Standard treatments for both types of lymphoma arechemotherapy, radiation therapy, and stem cell transplant. Additional standard therapies include surgery for Hodgkin lymphoma and targeted therapy, plasmapheresis, watchful waiting and biological therapy for NHL.

Assuming that incidence and survival rates follow recent trends, it is estimated that $13.4 billion¹ will be spent on lymphoma care in the United States in 2014.

Line graphs showing U.S. Hodgkin and Non-Hodkin Lymphoma Incidence and Mortality per 100,000 for whites and African Americans. In 2011 for Hodgkin lymphoma, whites and African Americans have the same incidence and whites have higher mortality than African Americans. In 2011 for non-Hodgkin lymphoma, whites have a higher incidence and mortality than African Americans. — Source: Surveillance, Epidemiology, and End Results (SEER) Program and the National Center for Health Statistics. Additional statistics and charts are available at the SEER Web site.

Examples of NCI Activities Relevant to Lymphoma

Members of the International Lymphoma Epidemiology Consortium (InterLymph), a group ofepidemiologists researching the causes of NHL, undertake research projects that pool data across studies or otherwise undertake collaborative research.
NCI’s Strategic Partnering to Evaluate Cancer Signatures (SPECS) program is exploring how information from molecular studies can be used to improve the care and outcomes of cancer patients. One SPECS project is using formalin-fixed, paraffin-embedded biopsy specimens from lymphoma patients to develop and validate a diagnostic and prognostic genetic profile assay to differentiate aggressive B-cell NHLs into prognostic groups.
The Integrative Cancer Biology Program (ICBP) combines experimental and clinical research with mathematical modeling to gain new insights into cancer biology, prevention, diagnosis, and treatment. One ICBP center is applying computational approaches to the study of differentiation in hematologic cancers, including follicular lymphoma.
NCI’s Division of Cancer Epidemiology and Genetics is conducting population and multidisciplinary research to discover the genetic and environmental causes of cancer, includingseveral studies on lymphoma.
The Lymphoid Malignancies Branch conducts translational research on the regulation of theimmune response and disorders of the immune system that underlie immunodeficiency and diseases such as leukemia and lymphoma.
Four lymphoma-specific Specialized Programs of Research Excellence (SPOREs) are moving results from the laboratory to the clinical setting. SPORE researchers are evaluating novel lymphoma therapies (including immunotherapies), studying lymphoma biology and epidemiology, and identifying lymphoma biomarkers.

Selected Advances in Lymphoma Research

Pie chart of NCI Lymphoma Research Portfolio. Percentage of total dollars by scientific area. Fiscal year 2013. Biology, 21%. Etiology/causes of cancer, 19%. Prevention, 3%. Early detection, diagnosis, and prognosis, 9%. Treatment, 35%. Cancer control, survivorship, and outcomes research, 7%. Scientific model systems, 6%. — Source: NCI Funded Research Portfolio. Only projects with assigned common scientific outline area codes are included. A description of relevant research projects can be found on the NCI Funded Research Portfolio Web site.

In a mouse model of B-cell lymphoma, the gut microbiome influences lymphoma incidence andlatency; the bacteria Lactobacillus johnsonii, which is more prevalent in the cancer-resistant mouse colony, can reduce inflammation and damage to genes. Published July 2013. [PubMed Abstract]
Studies in a cell co-culture system and a mouse xenograft model found that physical interaction between NHL cells and stromal cells conferred drug resistance and promoted cell growth and survival through the activation of a histone deacetylase and the oncogene c-Myc. These findings suggest that the microenvironment may mediate lymphoma progression and highlight potentialtherapeutic targets. Published November 2013. [PubMed Abstract]
In an uncontrolled prospective study, a low-intensity chemotherapy regimen that is less toxicthan current therapies was effective in adults with sporadic or immunodeficiency-associatedBurkitt lymphoma. Published November 2013. [PubMed Abstract]
In two mouse models of lymphoma, an antibody that stimulates natural killer cell-mediated tumor cell lysis enhanced the antitumor activity of the monoclonal antibody. Published December 2013. [PubMed Abstract]

Trends in NCI Funding for Lymphoma Research

NCI’s investment² in lymphoma research was $128.2 million in fiscal year (FY) 2013. In addition to the funding described in the graph, NCI supported $23.2 million in lymphoma research in FYs 2009 and 2010 using funding from the American Recovery and Reinvestment Act.

Bar graph of NCI Hodgkin Lymphoma/Non-Hodgkin Lymphoma Research Investment in 2009-2013: Fiscal year (FY) 2009, $149.1 million Lymphoma Funding of $4.97 billion Total NCI Budget. FY 2010, $137.0 million Lymphoma Funding of $5.10 billion Total NCI Budget. FY 2011, $139.8 million Lymphoma Funding of $5.06 billion Total NCI Budget. FY 2012, $135.1 million Lymphoma Funding of $5.07 billion Total NCI Budget. FY 2013, $128.2 million Lymphoma Funding of $4.79 billion Total NCI Budget. — Source: NCI Office of Budget and Finance.

Additional Resources for Lymphoma

What You Need To Know About™ Hodgkin Lymphoma
Describes possible risks, symptoms, diagnosis, and treatment for someone recently diagnosed with Hodgkin lymphoma.
What You Need To Know About™ Non-Hodgkin Lymphoma
Describes possible risks, symptoms, diagnosis, and treatment for someone recently diagnosed with non-Hodgkin lymphoma.
Hodgkin Lymphoma Home Page
NCI's gateway for information about Hodgkin lymphoma.
Non-Hodgkin Lymphoma Home Page
NCI's gateway for information about non-Hodgkin lymphoma.
Adult Hodgkin Lymphoma Treatment (PDQ®)
Expert-reviewed information summary about the treatment of adult Hodgkin lymphoma.
Adult Non-Hodgkin Lymphoma Treatment (PDQ®)
Expert-reviewed information summary about the treatment of adult non-Hodgkin lymphoma.
Clinical Trials for Hodgkin lymphoma
Clinical Trials for non-Hodgkin lymphoma

¹ Cancer Trends Progress Report, in 2010 dollars.
² The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.