Understanding the Grade of Non-Hodgkin's Lymphoma

With most types of lymphoma, a grading system is used to help identify how fast the cells are growing and how they might respond to treatment. Non-Hodgkin's lymphomas are categorized into low-grade and high-grade. Sometimes these may be referred to as indolent or aggressive lymphomas.

Low-grade tumors are slow-growing. They cause few symptoms. Although they respond to chemotherapy, they usually are not as curable as more aggressive tumors. They are sometimes called indolent tumors.

High-grade tumors are fast-growing. They can produce more severe symptoms. They usually respond to aggressive chemotherapy, and they may be curable. They are sometimes called aggressive tumors.

As with many things, there are exceptions to the rules. For instance, some low-grade lymphomas grow quickly. And some high-grade lymphomas respond well to treatment. So the International Prognostic Index (IPI) was developed to better predict how quickly most types of lymphoma might grow, how well people might respond to treatment, and whether treatment is even needed.

Your International Prognostic Index is determined by your doctor's evaluation of these factors.

  • Your age

  • The stage of your lymphoma

  • Whether the lymphoma has spread outside the lymph system

  • How well you can complete your daily activities. This is called your performance status.

  • Your blood (serum) level of lactate dehydrogenase (LDH). This substance increases in the presence of fast-growing tumors.

This index is useful for most lymphomas (other than for follicular lymphomas, which have their own index). It helps your doctor plan your treatment.

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