Lymphoma Classification

Classification of Non-Hodgkin Lymphomas

The purpose of further classifying non-Hodgkin lymphomas into specific categories is to describe the individual behavior and develop appropriate treatment strategies for each type of lymphoma. Non-Hodgkin lymphomas have been classified by several different systems over the past 30 years. The most common system used in the 1980’s-1990’s was the International Working Formulation (IWF). The IWF divided non-Hodgkin lymphomas into 3 grades based on the lymphoma’s appearance under a microscope. Since the IWF was utilized, a great deal of additional work has been performed that further classifies non-Hodgkin lymphomas into individual cancers, each with their own specific features and behavior. This newer system is called the Revised European American Lymphoma (REAL) classification and has been recommended for use by all doctors. Unfortunately, it will take several years for all doctors and the results of clinical trials to refer to the REAL system. This section allows patients to select the relevant type of non-Hodgkin lymphoma and learn about its treatment.

International Working Formulation Classification of Non-Hodgkin’s Lymphoma

High Grade:

• Large Cell Immunoblastic

• Lymphoblastic Lymphoma

• Small Noncleaved cell, Burkitt’s or non Burkitt’s

Intermediate Grade:

• Diffuse Large Cell

• Follicular Large Cell

• Diffuse Small Cleaved Cell

• Diffuse Mixed Small and Large cell

Low Grade:

• Small Lymphocytic/Chronic Lymphocytic Leukemia

• Follicular Small Cleaved Cell

• Follicular Mixed Small and Large Cell

Revised European American Lymphoma (REAL) Classification

• B-Cell Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia

• Lymphoplasmacytic Lymphoma

• Mantle Cell Lymphoma

• Follicle Center Lymphomas

• Marginal Zone B-Cell Lymphoma

• MALToma

• Diffuse Large B-Cell Lymphoma

• Burkitt’s Lymphoma

• Burkitt’s Like Lymphoma

• Precursor B or T-Cell Lymphoblastic Lymphoma/Leukemia