T-cell non-Hodgkin lymphoma (NHL) is a rare form of cancer that affects certain white blood cells called T cells. There are several types of T-cell NHL, each with a unique presentation and outlook.

In 2023, approximately 80,550 people in the United States will receive an NHL diagnosis. T-cell NHL diagnoses make up under 15% of all NHL cases.

There are different categories of T-cell NHL, including peripheral T-cell lymphoma (PTCL). Most cases of T-cell NHL involve the rapid growth of cancerous cells in tissues of the lymphatic system.

This article discusses what T-cell NHL is, why it occurs, and its treatment options.

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T-cell NHLs are types of cancer that affect the lymphatic system, which plays an important part in fighting infections as part of the immune system. It contains a type of white blood cell that health experts call lymphocytes, which include B cells and T cells.

Healthy B cells can create antibodies that target viruses, bacteria, or other infectious agents. Healthy T cells attack and kill cells in the body that have acquired an infection or become cancerous.

When these lymphocytes become damaged or mutated, they may grow uncontrollably. These cancerous cells can form tumors that can invade tissues throughout the body.

T-cell NHL involves lymphomas made of cancerous T cells.

There are several different forms of T-cell NHL. The two main types of this disease include peripheral T-cell lymphoma (PTCL) and T-lymphoblastic lymphoma.

Peripheral T-cell lymphoma

There are many PTCL subtypes — some include the following:

  • PTCL, not otherwise specified (PTCL-NOS): Around 36% of PTCL cases are PTCL-NOS, which most often occurs among individuals in their 50s and 60s. This type of PTCL progresses rapidly and often returns following treatment.
  • Cutaneous T-cell lymphoma (CTCL): This form of PTCL begins within the skin and typically grows more slowly than other types. People with CTCL may experience skin symptoms that mimic those of dermatitis, psoriasis, or eczema.
  • Anaplastic large cell lymphoma: This rare form of PTCL can either occur throughout the entire body or on the skin. Cases that begin on the skin are generally less aggressive.
  • Angioimmunoblastic T-cell lymphoma: This rare and aggressive form of PTCL is most common in older adults. It often affects the lymph nodes, the bone marrow, and the spleen or liver.
  • Adult T-cell leukemia or lymphoma (ATLL): This form of lymphoma may affect the skin, blood, lymph nodes, or other body parts. The human T-cell leukemia virus type-1 virus can lead to ATLL, but only a small percentage of people with this virus develop this form of cancer.
  • Nasal NK or T-cell lymphoma: This subtype affects natural killer cells, which are similar to T cells. Nasal NK or T-cell lymphoma is aggressive and has links to the Epstein-Barr virus.
  • Enteropathy-type T-cell lymphoma: Individuals with this form of T-cell NHL develop lymphoma in their intestines. Some individuals may experience celiac disease before developing this lymphoma.

Health experts further divide some of these PTCL subtypes. For example, CTCL includes mycosis fungoides, a rare type of blood cancer that starts in the skin, and Sézary syndrome, an aggressive form of a type of blood cancer.

T-lymphoblastic lymphoma

T-lymphoblastic lymphoma makes up around 1% of all lymphomas. It most commonly affects younger individuals and males. This type of lymphoma is fast-growing and typically starts in the thymus.

Healthcare professionals may consider the disease to be a lymphoma or a type of acute lymphoblastic leukemia, depending on how much it affects the bone marrow.

The symptoms of T-cell NHL can vary according to the individual, disease subtype, and disease severity. Some of the more common symptoms may include:

Individuals experiencing any unusual symptoms should visit a doctor to learn more.

There is no single cause of T-cell NHL that scientists are aware of. However, some researchers suggest that certain genetic mutations may cause this cancer to develop. Chronic inflammation and certain infections may also be contributing factors.

Researchers have identified risk factors that can increase an individual’s risk of developing T-cell NHL. These may include:

  • having a family history of blood cancer
  • smoking
  • working with or having exposure to hazardous chemicals
  • having psoriasis or eczema
  • older age
  • taking immunosuppressive drugs

Anyone who believes they may be at risk of developing T-cell NHL should speak with their doctor. A healthcare professional can assess individual risk factors and recommend a course of action if necessary.

The process for diagnosing T-cell NHL can vary widely, particularly between PTCL subtypes. Diagnostic tests may include:

Because CTCL occurs on the skin, a dermatologist may be able to provide a diagnosis. If they notice unusual skin growths or swollen lymph nodes, they may perform a skin biopsy. During this process, they remove a skin sample to test for cancerous cells.

Diagnosis for CTCL may then involve more specialists who can conduct additional tests. These may include blood tests and genetic analyses.

Individuals showing signs of T-cell NHL should speak with a healthcare professional to learn more about the diagnostic process.

Each type of T-cell NHL requires a unique treatment plan. This can differ between individuals, cancer subtypes, and cancer stages. Some treatment options for T-cell NHL include:

Researchers are also exploring new options for targeted treatment approaches. Treatment with chimeric antigen receptor-T cells (CAR Ts) is one such new development.

This treatment involves genetically modifying an individual’s T cells with a chimeric antigen receptor. This receptor can recognize and bind to certain cancer cells.

After modifying the T cells in the lab, a medical professional inserts the cells back into the person with T-cell NHL. These modified cells can recognize and attack cancerous cells.

CAR T cell therapy has demonstrated promising results in clinical trials. However, researchers are still working to improve the safety and efficacy of this potential T-cell NHL treatment.

T-cell NHL is a form of cancer that begins in T cells and can spread to different parts of the body. It may occur on or below the skin or in other parts of the body, such as the nose, spleen, or liver. Symptoms vary depending on the subtype of T-cell NHL a person is experiencing.

Although health experts do not fully understand the causes of this cancer, they have identified risk factors that may increase a person’s risk of developing T-cell NHL, including older age. Healthcare professionals may perform a range of tests to diagnose this disease.

Treatment options vary according to the individual and type of T-cell NHL. A person should speak with a healthcare professional if they think they are experiencing symptoms of T-cell NHL or if they wish to learn more about their risk for developing the condition.