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Understanding the Grade of Non-Hodgkin 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 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 may not need to be treated right away and often respond well to chemotherapy when they do, 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. 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. (60 or below is better.)

  • The stage of your lymphoma. (Stage I or II is better.)

  • Whether the lymphoma has spread outside the lymph system. (Less spread is better.)

  • How well you can complete your daily activities. This is called your performance status. (Normal performance status is better.)

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

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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