Aggressive Non-Hodgkin Lymphoma Prognosis

This cancer grows quickly, responds well to treatment

Table of Contents
View All
Table of Contents

The prognosis for aggressive non-Hodgkin lymphoma depends on several factors, including a person's age, cancer stage, and treatment response. The four-year survival rate for some people with aggressive non-Hodgkin lymphoma can be 79% to 94%. In some cases, aggressive non-Hodgkin lymphoma can be cured.

This article covers the prognosis for aggressive non-Hodgkin lymphoma and how different factors affect survival rate. You'll also learn about the scoring system healthcare practitioners use to evaluate each case.

An elderly man getting a checkup
FatCamera / Getty Images

Prognosis vs. Life Expectancy vs. Survival

Cancer prognosis is an estimate of how well someone with cancer will respond to treatments.

You may also hear these terms in discussions about aggressive non-Hodgkin lymphoma prognosis:

  • Life expectancy is an estimate of how long someone with cancer is expected to live.
  • Survival rates estimate the percentage of people with a disease who will be alive at a certain point after they are diagnosed (five-year survival rates are commonly used).
  • Median survival is the time after a cancer diagnosis when 50% of people are alive and 50% have died.

It's important to remember that estimates are just that. They are not specific to one person, and many individual factors determine if someone's aggressive non-Hodgkin lymphoma prognosis will be better or worse than expected.

In addition, keep in mind that aggressive non-Hodgkin lymphoma prognosis statistics—like those for any disease—are based on existing data. This means they show how someone would have done in the past, not how well they may do today with access to newer medications and treatments.

Aggressive Non-Hodgkin Lymphoma Prognosis Scoring System

Aggressive non-Hodgkin lymphoma is a fast-growing disease but it responds well to treatment and many patients can be cured.

The outcome for people with aggressive non-Hodgkin lymphoma depends on five well-established prognostic factors that make up the International Prognostic Index (IPI):

  • Age
  • Blood test results
  • Performance status
  • Cancer stage
  • Organ involvement outside the lymphatic system

Usually, 1 point is assigned to each category and the points are totaled. A patient gets a final score between 0 and 5 that is used to both predict their prognosis and serve as a comparison for past scores.


Age is an important prognostic factor in aggressive non-Hodgkin lymphoma. People who develop aggressive non-Hodgkin lymphoma when they are younger than 60 years of age do better than people diagnosed over the age of 60.

Age Score: Using the IPI, 1 point is given for being over age 60 and 0 points for being under age 60.

Blood Test Results

Serum lactate dehydrogenase (LDH) is a blood test that can show how much disease there is in the body in a person with aggressive non-Hodgkin lymphoma. The more the disease there is, the higher the value of LDH will be.

People with aggressive non-Hodgkin lymphoma and high levels of LDH do worse than people who have normal levels.

LDH Test Score: Using the IPI, 1 point is given for an elevated level and 0 points are given for a normal level.

Performance Status

Performance status measures the fitness of a person with non-Hodgkin lymphoma. It's a way to track a person's symptoms and see how well they are able to care for themselves and go about their day-to-day lives independently.

In aggressive non-Hodgkin lymphoma and other cancers, people with higher performance scores do better after treatment than people who are sicker or dependent on others for help with their daily activities.

Performance Status Score: Using the IPI, 1 point is given if you need a lot of assistance in daily activities and 0 points are given if you can manage daily activities without help.

Cancer Stage

As with other types of cancer, the stage of aggressive non-Hodgkin lymphoma is also a key factor in a person's prognosis. People with early-stage disease (stages 1 and 2) have better outcomes than people with advanced-stage disease (stages 3 and 4).

Cancer Stage Score: Using the IPI, 1 point is given for having stage 3 or 4 cancer, and 0 points are given for stage 1 or 2.

Involvement of Organs Outside the Lymph System

Aggressive non-Hodgkin lymphoma is a cancer of the lymphatic system. However, when cancer gets into organs outside of it—like the liver, spine, or brain—treatments may not work as well and people will have worse outcomes.

Organ Involvement Score: Using the IPI, 1 point is given if one or more organs outside the lymph system are affected and 0 points are given if no organs outside the lymphatic system are affected.

Are Aggressive Non-Hodgkin Lymphoma Outcomes Improving?

Researchers have looked at the change in survival rates over time for people with aggressive non-Hodgkin lymphoma and other lymphomas by comparing prognostic factors.

Not long ago, the five-year survival rate for a person with aggressive non-Hodgkin lymphoma and 0 to 1 point(s) was 75%, and 30% for people with 4 to 5 points. However, researchers have done more recent estimates of these rates for people with aggressive non-Hodgkin lymphoma who have had access to newer treatments.

Today, people with aggressive non-Hodgkin lymphoma and 0 points may have a four-year survival rate of 94%, and people with 1 point may have a five-year survival rate of 79%.


If you are diagnosed with aggressive non-Hodgkin lymphoma, you may fear how it will affect your life expectancy. The prognosis for aggressive non-Hodgkin lymphoma depends on many factors, like how old you are, how you respond to treatment, and the cancer stage.

Remember that cancer prognosis numbers are only an estimate. Each person has individual factors that will influence their experience with cancer. Even if your prognosis is good, it's important to seek out support for coping with aggressive non-Hodgkin lymphoma.

That said, treatments for aggressive non-Hodgkin lymphoma have improved. People have a better outlook today and often live longer than they used to—and some people can even be cured.

Frequently Asked Questions

  • What is the most aggressive non-Hodgkin lymphoma?

    Burkitt lymphoma is considered the most aggressive type of non-Hodgkin lymphoma. Of all cancers, it's one of the fastest-growing—but it's also rare.

  • How fast does aggressive non-Hodgkin lymphoma spread?

    Some lymphomas start out growing slowly over years, even decades. Once they become aggressive, they grow fast. Some aggressive non-Hodgkin lymphomas can even double in size in just one month.

  • Can aggressive non-Hodgkin lymphoma be cured?

    Some cases of aggressive non-Hodgkin lymphoma respond well to treatment and go into remission. If a person's cancer does not come back, they can be cured of aggressive non-Hodgkin lymphoma.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pfreundschuh M. Age and Sex in Non-Hodgkin Lymphoma Therapy: It’s Not All Created Equal, or Is It? American Society of Clinical Oncology Educational Book. 2017;37:505-511. doi:10.14694/edbk_175447

  2. van de Schans SA, van Steenbergen LN, Coebergh JW, Janssen-Heijnen ML, van Spronsen DJ. Actual prognosis during follow-up of survivors of B-cell non-Hodgkin lymphoma in the NetherlandsHaematologica. 2014;99(2):339–345. doi:10.3324/haematol.2012.081885

  3. Yadav C, Ahmad A, D'Souza B, et al. Serum Lactate Dehydrogenase in Non-Hodgkin's Lymphoma: A Prognostic IndicatorIndian J Clin Biochem. 2016;31(2):240–242. doi:10.1007/s12291-015-0511-3

  4. PDQ Adult Treatment Editorial Board. Adult Non-Hodgkin Lymphoma Treatment (PDQ): Health Professional Version. 2019 Sep 18. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-.

  5. Cancer Treatment Centers of America. Non-Hodgkin Lymphoma Types.

  6. Bristol Meyers Squibb. The Many Faces of Lymphoma.

  7. Leukemia & Lymphoma Society. Treatment for Aggressive NHL Subtypes.

Additional Reading
  • American Cancer Society. Survival rates and factors that affect prognosis (outlook) for non-Hodgkin lymphoma. Updated 01/22/16.

By Indranil Mallick, MD
 Indranil Mallick, MD, DNB, is a radiation oncologist with a special interest in lymphoma.