Survival statistics for non-Hodgkin lymphoma

Survival statistics for non-Hodgkin lymphoma (NHL) are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival.

There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for NHL and what they mean to you.

Survival varies with each stage and particular type of NHL. There are more than 30 different types of NHL and each behaves and responds to treatment differently. Doctors will consider each type’s individual behaviour, prognostic factors and expected response to treatment before they make a prognosis.

Net survival

Net survival represents the probability of surviving cancer in the absence of other causes of death. It is used to give an estimate of the percentage of people who will survive their cancer.

In Canada, the 5-year net survival for NHL is 68%. This means that about 68% of people diagnosed with NHL will survive for at least 5 years.

Survival by stage, type of NHL and prognostic factors

Survival varies with each stage, type of NHL and the number of poor prognostic factors defined by the IPI index. Generally, the earlier NHL is diagnosed and treated, the better the outcome. There are many effective treatments available for NHL and it often responds well to treatment.

There are no specific Canadian statistics available for the different stages or types of NHL. The following information comes from a variety of sources. It may include statistics from other countries that are likely to have similar outcomes as in Canada.

Prognostic indexes

Experts have developed 2 prognostic indexes to predict the general outcome for fast-growing (aggressive) types of NHL and for follicular lymphoma. These indexes include progression-free survival and observed survival rates.

Progression-free survival is the length of time during and after treatment that people with a particular cancer live without the disease progressing, or becoming worse.

Observed survival, or overall survival, is the proportion of people with a particular cancer who are alive at a certain point in time.

Prognostic index for aggressive NHLs

The Revised International Prognostic Index (R-IPI) was developed to help determine the outcome for people with fast-growing types of NHL. It helps doctors assign people to risk groups based on how many of the following poor prognostic factors they have:

  • older than 60 years of age
  • the NHL is stage 3 or 4
  • the lactate dehydrogenase (LDH) level is above normal
  • the lymphoma cells have spread outside of the lymph nodes (called extranodal spread)
  • a poor performance status

Survival rates for aggressive NHLs

Number of poor

prognostic factors

5-year observed survival

0 or 1

82%

2 or 3

50%

4 or 5

25%

Prognostic index for follicular lymphoma

The Follicular Lymphoma International Prognostic Index (FLIPI) helps doctors assign people to low-, intermediate- or high-risk groups based on how many of the following poor prognostic factors they have:

  • older than 60 years of age
  • the NHL is stage 3 or 4
  • the lactate dehydrogenase (LDH) level is above normal
  • the hemoglobin level is less than 120g/L
  • there are lymphoma cells in more than 4 lymph node areas

Survival rates for follicular lymphoma

Number of poor

prognostic factors

Risk group

5-year observed survival

10-year observed survival

0 or 1

low

91%

71%

2

intermediate

78%

51%

3–5

high

53%

36%

Questions about survival

Talk to your doctor about your prognosis. A prognosis depends on many factors, including:

  • your health history
  • the type of cancer
  • the stage of the cancer
  • certain characteristics of the cancer
  • the treatments chosen
  • how the cancer responds to treatment

Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

Expert review and references

  • American Cancer Society. Non-Hodgkin Lymphoma. 2014: http://www.cancer.org/acs/groups/cid/documents/webcontent/003126-pdf.pdf.
  • Canadian Cancer Statistics Advisory Committee . Canadian Cancer Statistics 2019 . Toronto, ON : Canadian Cancer Society ; 2019 : https://cancer.ca/en/research/cancer-statistics/past-editions.
  • Faber EA, Vose JM, Armitage JO, Bierman PJ . Diagnosis and treatment of non-Hodgkin's lymphoma of adults. Wiernik PH, Goldman JM, Dutcher JP, Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 47: 1027-1047.
  • Freedman AS, Jacobson CA, Mauch P, Aster JC . Non-Hodgkin lymphoma. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 103:1552-1583.
  • Manson SD & Porter C . Lymphomas. Yarbro, CH, Wujcki D, & Holmes Gobel B (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 60: pp. 1458-1512.
  • Sanjay Vinjamaram. Non-Hodgkin Lymphoma. WebMD LLC; 2015: http://emedicine.medscape.com/article/203399-overview#showall.