Indolent Lymphoma

Indolent lymphoma is a slow-growing type of non-Hodgkin lymphoma. This condition starts in white blood cells in your lymphatic system. You can have this condition for years before it causes symptoms. While there’s no cure for indolent lymphoma, treatment often puts it into remission. That means you don’t have symptoms and tests show no signs of it. But the condition can come back.

Types of indolent lymphoma

Healthcare providers classify indolent lymphoma by the type of white blood cell it affects. You can have an indolent B-cell lymphoma or an indolent T-cell lymphoma.

Indolent B-cell lymphoma types are:

• Chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL): These diseases develop in your blood or bone marrow.
• Cutaneous B-cell lymphoma: This rare lymphoma starts in your skin.
• Follicular lymphoma: This is the most common indolent lymphoma. You may develop follicular lymphoma in your lymph nodes, bone marrow and other organs.
• Waldenström macroglobulinemia: This is a rare type of lymphoma that typically grows in your bone marrow but may also affect parts of your lymphatic system.
• Marginal zone lymphomas: These conditions develop in your stomach, lungs, skin, thyroid, salivary glands and tissues around your eyes.
• Mantle cell lymphoma: This type often starts in your lymph nodes, bone marrow and spleen.

Indolent T-cell lymphoma types are:

• Cutaneous T-cell lymphoma (CTCL): This group of blood cancers affects your skin. There are many types of CTCL. Mycosis fungoides is one of most common types.
• Subcutaneous panniculitis-like T-cell lymphoma: This form affects tissues under your skin.

Indolent lymphoma symptoms

This condition may not cause symptoms because it grows so slowly. Some people learn they have it when routine blood tests detect issues with their white blood cells. When symptoms start, you may experience:

• Heavy night sweats
• Pain in your belly, bones or chest
• Persistent fatigue
• Rash
• Swollen lymph nodes in your neck, armpits or groin
• Unexplained fever
• Unexplained weight loss

Indolent lymphoma causes

This condition happens when genetic changes (mutations) make abnormal B cells and T cells. These abnormal cells multiply faster than normal. Sometimes, the cells form cancerous tumors. Other times, abnormal cells crowd out healthy blood cells and platelets.

The genetic changes that lead to indolent lymphoma happen after you’re born. Experts don’t know what triggers the genetic change.

Risk factors

There are factors that may increase your risk:

• Age: This condition typically affects people 50 and over.
• Sex: Men are more likely to have this condition.
• Race: This condition typically affects people who are white. But being Black increases your risk of cutaneous T-cell lymphoma.
• Health: Some autoimmune diseases, conditions that weaken your immune system and infections increase your risk.
• Family health history: Your risk can increase slightly if close family members have lymphoma, but indolent lymphoma isn’t a familial or inherited disease.

Complications

Some indolent lymphomas can cause other conditions, like:

• Autoimmune disorders: Marginal zone lymphoma and Waldenström macroglobulinemia may coexist with autoimmune disorders like rheumatoid arthritis or Hashimoto’s disease.
• Cardiovascular disease: Follicular lymphoma and cutaneous T-cell lymphoma may increase the risk of diseases like atrial fibrillation and heart failure. Cancer treatment for indolent lymphoma may also increase your risk.
• Diffuse large B-cell lymphoma (DLBCL): Follicular lymphoma, CLL and marginal zone lymphoma can turn into DLBCL, an aggressive lymphoma.
• Hyperviscosity syndrome: This condition makes your blood thick so it can’t flow through your blood vessels. It’s a complication of Waldenström macroglobulinemia.
• Infections: Research shows indolent lymphoma increases your risk for infections.
• Organ dysfunction: Tumors growing in lymph nodes may affect your liver, lungs, spleen and kidneys.

Cancer medications to treat indolent lymphoma can also cause complications, including:

• Infertility: Cancer treatment with chemotherapy may cause this condition.
• Second cancers: These are new cancers that develop in different areas of your body.

Mental health issues are another potential complication. One study shows people with indolent lymphoma may develop anxiety, depression or post-traumatic stress disorder.

How doctors diagnose this condition

A healthcare provider will do a physical exam. They’ll ask when your symptoms started and if they’ve gotten worse. They may do tests like:

• Blood tests for cancer: They may also do tests that check for certain viral infections.
• Imaging tests: You may have CT scans, MRI tests or PET scans.
• Biopsy: Your provider gets a tissue sample from your lymph nodes or a tumor in another part of your body.

How is indolent lymphoma treated?

Healthcare providers may use several treatments to manage this condition. Treatments may include:

• Active surveillance: Your provider may recommend this if you don’t have symptoms. They’ll do regular checkups and start treatment as soon as you have symptoms.
• Chemotherapy: This is a common treatment for non-Hodgkin lymphoma, including indolent lymphoma.
• Immunotherapy: This treatment works by boosting your immune system so it can do more to kill cancer cells.
• Radiation therapy: In this treatment, energy beams from a machine target and kill cancer cells.

What’s the life expectancy for indolent lymphoma?

Life expectancy varies, depending on the condition type. For example, one study found people lived for 32 years after successful treatment for follicular lymphoma. Another study on mantle cell lymphoma survival rates showed 4 out of 10 people were alive 10 years after diagnosis. 

Is there anything I can do to feel better?

You may live for years with some types of indolent lymphoma. Self-care can help you manage the challenges that this condition can cause. Participating in a cancer survivorship program may be another helpful option. These programs focus on your health and quality of life.