Lymphoblastic Lymphoma Prognosis and Treatment

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Lymphoblastic lymphoma is an uncommon form of fast-growing, aggressive non-Hodgkin lymphoma (NHL), most often seen in teenagers and young adults. Another name for it is precursor lymphoblastic lymphoma. It usually is a tumor of the T cells but sometimes the cells are B cells, and those terms will be used in naming.

A lymphoma cancer cell.


A blast cell is an immature cell in the bone marrow that gives rise to mature lines of blood cells, In the case of lymphoblastic lymphoma, the disordered cell is a lymphoblast that would normally produce a healthy line of immune system cells, the lymphocytes. The lymphoblasts would normally live in the bone marrow, producing lymphocytes that circulate in the blood and lymphatic system, including the lymph nodes.

What Produces Lymphoblastic Lymphoma?

Lymphoblastic lymphoma is a cancer of immature lymphoblasts. It arises more commonly from T-lymphoblasts than B-lymphoblasts. It is a very aggressive lymphoma, also called high-grade lymphoma. That means that the lymphoma grows quickly, and can spread fast to different parts of the body. In many ways, it is similar to leukemia. In this case, it shades into the diagnosis of acute lymphoblastic leukemia if there is more than 25% lymphoblasts in the bone marrow.

Get familiar with the names given to the different types of NHL in the article on NHL types.

Who Gets Lymphoblastic Lymphoma?

Lymphoblastic lymphoma mostly affects young people in their late teens or early twenties. It is more common in men than in women. It accounts for 25%-30% of NHL in children.

How the Disease Affects the Body

This lymphoma is very fast growing. Most patients develop severe symptoms within a short span of time. Lymph nodes in the mediastinum (the central part of the chest between the lungs) are the most commonly affected. This results in a mass in the chest that leads to breathing problems and cough. Water may also accumulate within the lungs. The bone marrow is commonly involved. The brain and spinal cord may also be affected in a number of cases.

Diagnosis and Tests

The diagnosis of lymphoma is generally done with a lymph node biopsy if enlarged nodes can be easily accessed, or a needle aspiration (FNAC) under the guidance of CT-scans or ultrasound scans. The disease is confirmed as a lymphoma, and the type of lymphoma is determined by looking at its cells under the microscope and special tests. Newly diagnosed patients have to undergo a series of tests to determine how far the disease affects the body. See the section on tests for the newly diagnosed.


The prognosis of lymphoblastic lymphoma is similar in many respects to leukemias. It depends on a number of factors including the stage of the disease. The factors are described in the section on prognostic factors of Non-Hodgkin Lymphoma (NHL).


Lymphoblastic lymphoma is treated more like leukemia than like another type of lymphoma. Chemotherapy is the primary treatment.

Chemotherapy is given in three phases: induction, consolidation, and maintenance.

  • Induction chemotherapy involves the administration of a number of drugs through infusion and tablets over a few weeks in the hospital.
  • Following this, a few drugs are administered in infusion periodically over a few months to remove any remaining cancer cells. This is called consolidation.
  • Maintenance involves the use of drugs usually in oral form over a few years.

A number of patients with lymphoblastic lymphoma achieve a cure with intensive chemotherapy. In adults, intensive combination chemotherapy is given and a bone marrow transplant may be performed.

A newer treatment option is chimeric antigen receptor (CAR) T-cell therapy. CAR-T is a type of immunotherapy that uses patients' own immune cells to treat their cancer.

In CAR T-cell therapy, immune cells are removed from a patient's blood, modified in a laboratory using a drug, and then placed back into the body to fight cancer. Yescarta (axicabtagene ciloleucel) and Kymriah (tisagenlecleucel) are CAR T-cell treatments approved for certain patients with lymphoblastic lymphoma.

4 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. American Cancer Society. Types of Non-Hodgkin Lymphoma in Children.

  2. Aggarwal R, Rao S, Dhawan S, Bhalla S, Kumar A, Chopra P. Primary mediastinal lymphomas, their morphological features and comparative evaluation. Lung India. 2017;34(1):19-24. doi:10.4103/0970-2113.197115

  3. National Cancer Institute. Childhood Non-Hodgkin Lymphoma Treatment–for health professionals (PDQ).

  4. National Cancer Institute. Adult Non-Hodgkin Lymphoma Treatment–for health professionals (PDQ).

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