Three major therapeutic advances during the 20TH century improved survival rates of adults with non-Hodgkin’s lymphoma (NHL): the use of external beam orthovoltage radiotherapy for early-stage NHL,1 CHOP chemotherapy for aggressive-histology NHL,2 and high-dose chemotherapy with autologous stem cell transplantation (HDCT/ASCT) for relapsed NHL.3 Some disappointments included lack of survival benefit for several approaches: immediate vs delayed chemotherapy in patients with asymptomatic advanced-stage indolent NHL,4 intensive combination chemotherapy regimens over single-agent chemotherapy for indolent NHL,5 and dose-intensive 3RD generation chemotherapy regimens or front-line HDCT/ASCT over conventional CHOP for aggressive histology NHL.6,7 Recently, a 4TH major advance in NHL management has become evident: the development of effective immunologic therapy with the chimeric anti-CD20 monoclonal antibody rituximab.8 Other encouraging developments in NHL include:

• the revisedWHOpathologic classification for lymphoid malignancies9
• the promise for further refinements through lymphoma genome profiling9,10,11
• prognostic scoring systems which may help stratify patients to receive different treatment strategies12,13
• functional imaging with FDG-positron emission tomography (PET)14
• radioimmunoconjugate therapy (RIT)15

Here, Oncology Exchange reviews these recent advances in the context of the most common NHL subtypes.