Non-Hodgkin’s lymphoma (NHL) is diagnosed in over 80,000 people each year in the U.S., making it one of the more common cancer types. Recently, NHL has become one of the primary injuries in a number of class action mass torts because it has been linked to chronic exposure to certain chemicals. NHL is also at issue in many medical malpractice cases involving diagnostic errors.
This page will provide a basic medical overview of non-Hodgkin’s lymphoma and discuss its involvement in various product liability and mass tort cases.
The Lymphatic System
The lymphatic system is comprised of various tissues, thin tubes (called lymphatic vessels) and lymph nodes that run throughout the body. The other major organs in the lymphatic system include the tonsils, thymus, liver, and spleen.
The lymphatic system has two primary functions. The first is to circulate a watery fluid call lymph back into the circulatory system. Lymph is the excess blood plasma that seeps through the body’s capillaries into the tissue during blood circulation. The second major function of the lymphatic system is help support the body’s immune system by producing and releasing white blood cells (lymphocytes) and other key immune cells. These cells target and attack bacteria and other foreign invaders inside in the body.
Non-Hodgkin’s lymphoma (NHL) is a type of cancer that originates in the lymphatic system. NHL occurs when the white blood cells produced by the lymphatic system become abnormal and eventually grown into cancerous tumors.
NHL is one general category or type of lymphoma. The other general category is Hodgkin’s lymphoma. NHL can originate anywhere that lymph tissue is found in the body. The most common sites of origination for NHL are:
- Lymph Nodes: lymph nodes are small pockets or sacs located throughout the body (including the chest, abdomen, pelvis, and neck) which contain white blood cells and other key immune defense cells. They are connected by the lymphatic vessels.
- Spleen: the spleen is an organ found under the lower left rib cage. It helps produces immune fighting cells and also filters damaged cells and waste from the blood.
- Bone Marrow: the tissue inside the inner bone which is where blood cells are made.
Other potential origination sites for NHL include the adenoids, tonsils, and thymus.
Types of Non-Hodgkin Lymphoma
There are various different subtypes of non-Hodgkin lymphoma depending on what type of white blood cells are involved (B vs T cells), and how old the cells are when the become cancerous.
- B Cell Lymphoma: B-cell lymphoma is the most common type of NHL. Over 85% of all NHL cases are classified as B-cell. There are numerous different subtypes of B-cell lymphoma.
- T-Cell Lymphoma: T-cell lymphoma is a rare type of NHL, accounting for less than 15% of all NHL cases. There are also many different subtypes of T-Cell NHL.
The various types of NHL are also group based on how fast the cancer cells grown and spread. NHL types that grow and spread slowly are known as “indolent lymphomas.” Follicular lymphoma is most common type of indolent NHL in the U.S.
Those types of NHL that feature fast growing and spreading cells are classified as “aggressive lymphomas.” Diffuse large B cell lymphoma is the most common form of aggressive NHL.
Non-Hodgkin Lymphoma Statistics
Just over 80,000 cases of NHL were diagnosed in the U.S. last year, with 44,000 cases being diagnosed in men vs. 36,000 in women. This ranks NHL as the 7th most common type of cancer in the U.S.
The 5-year survival rate for NHL (all stages) in the U.S. is 73%. The survival rate for localized and regional NHL (Stages I-III) is the 74%, while the 5-year survival rate for stage IIIC or higher drops down to 54%. The survival rate for follicular NHL is much higher at 90%.
NHL is primary diagnosed in older patients. Over half of all NHL patients are 65 or older when diagnosed. However, NHL does occur in younger patients, including children and teens. Just over 11,000 people will die each year in the U.S. from NHL.
Treatment Options for NHL
Treatment options for NHL varying depending on what type of NHL and whether it is classified as aggressive or slow growing. For some non-aggressive cases, treatment may not be recommended right away. Instead, regularly monitoring may be advised.
Immediate treatment will be required for more aggressive forms of NHL. The primary treatment option for NHL is chemotherapy. Chemotherapy involves the use of very strong drugs which kill the cancer cells.
Radiation therapy is another common treatment option for NHL. For certain types of NHL, particularly those that grow slowly and are located in one area, radiation therapy may be the only advised treatment. Radiation therapy uses targeted high-power radiation beams to kill free cancer cells inside the body. Other treatments include targeted drug therapy and chimeric antigen receptor (CAR)-T cell therapy.
One thing that is unique about treatment options for NHL is that surgery is usually not involved. However, in some cases of NHL, a bone marrow transplant is a recommended treatment option. This involves transplanting healthy bone marrow cells from a donor after suppressing the patient’s unhealthy marrow cells.
Risk Factors for NHL
There are a number of known risk factors that make certain people more likely to develop non-Hodgkin lymphoma compared to others. The risk factors for NHL include:
- Age: older people are much more likely to get NHL (this is generally true for almost all cancers), although certain types of NHL are actually more common in young people.
- Gender: men have a slightly higher risk of developing NHL compared to women.
- Race: in the U.S., white people are much more likely to develop NHL than any other racial or ethnic group.
- Genetics: anyone with a family history of NHL is at an increased risk of developing NHL themselves.
- Chemical Exposure: scientific studies have identified an association between NHL and chronic exposure to a number of different toxic chemicals. Chemicals that have been linked to NHL include benzene and certain herbicides (weed killers).
Roundup May Cause Non-Hodgkin Lymphoma
Roundup was once the most popular weed-killer product on the market. About 10 years ago, however, new research began to emerge which found that prolonged exposure to the active chemical in Roundup (glyphosate) may cause non-Hodgkin lymphoma. There is now a well-established body of scientific research showing a link between glyphosate exposure and NHL.
The evidence linking Roundup to NHL prompted a wave of thousands of product liability lawsuits by plaintiffs who claimed that their NHL was caused by years of regularly using Roundup. Bayer has already settled a large percentage of the Roundup lawsuits and has set aside an estimated $16 billion for Roundup-related liabilities.
Camp Lejeune NHL Lawsuits
Camp Lejeune is a large Marine Corps base in North Carolina. From the 1950s to the late 1980s, the water supply at Camp Lejeune was highly contaminated with very toxic chemicals. A new federal law was recently passed allowed victims to file Camp Lejeune lawsuits against the federal government for injuries connected to the contaminated water.
Non-Hodgkin lymphoma is one of the cancer types that has been definitively linked to exposure to the chemicals in the water at Camp Lejeune. The ATSDR and VA have both identified NHL as one of the diseases that are “presumptively” related to Camp Lejeune.
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