Non-Hodgkin's Lymphoma

Adult non-Hodgkin's lymphoma is a disease in which malignant (cancer) cells form in the lymph system. The lymph system is part of the immune system and is made up of the following:

  • Lymph: Colorless, watery fluid that travels through the lymph system and carries white blood cells called lymphocytes. Lymphocytes protect the body against infections and the growth of tumors.
  • Lymph vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.
  • Lymph nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.
  • Spleen: An organ that makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is on the left side of the abdomen near the stomach.
  • Thymus: An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.
  • Tonsils: Two small masses of lymph tissue at the back of the throat. The tonsils make lymphocytes.
  • Bone marrow: The soft, spongy tissue in the center of large bones. Bone marrow makes white blood cells, red blood cells, and platelets.

Because lymph tissue is found throughout the body, adult non-Hodgkin's lymphoma can begin in almost any part of the body. Cancer can spread to the liver and many other organs and tissues.

Non-Hodgkin's lymphoma in pregnant women is the same as the disease in nonpregnant women of childbearing age. However, treatment is different for pregnant women. This information includes treatment of non-Hodgkin's lymphoma during pregnancy.

Lymphomas are divided into two general types: Hodgkin's lymphoma and non-Hodgkin's lymphoma. This information is about the treatment of adult non-Hodgkin's lymphoma. For more information about this disease in children, visit the National Cancer Institute.

Waldenström macroglobulinemia is a type of non-Hodgkin's lymphoma begins in a type of white blood cell called B lymphocytes. Certain B lymphocytes multiply out of control and make large amounts of a protein called monoclonal immunoglobulin M (IgM) antibody. High levels of IgM in the blood cause the blood to thicken and leads to many of the symptoms of Waldenström macroglobulinemia. Waldenström macroglobulinemia is also called lymphoplasmacytic lymphoma.

Risk Factors
Symptoms
Screening and Diagnosis
Staging
Treatment
Support

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Risk Factors

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for adult non-Hodgkin's lymphoma include the following:

  • Being older, male, or white.
  • Having one of the following medical conditions:
    • An inherited immune disorder (for example, hypogammaglobulinemia or Wiskott-Aldrich syndrome).
    • An autoimmune disease (for example, rheumatoid arthritis, psoriasis, or Sjögren syndrome).
    • HIV /AIDS.
    • Human T-lymphotrophic virus type I or Epstein-Barr virus.
    • A history of Helicobacter pylori infection.
  • Taking immunosuppressant drugs after an organ transplant.
  • Being exposed to certain pesticides.
  • A diet high in meats and fat.
  • Past treatment for Hodgkin lymphoma.

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Symptoms

These and other symptoms may be caused by adult non-Hodgkin's lymphoma. Other conditions may cause the same symptoms. Check with your doctor if you have any of the following problems:

  • Painless swelling in the lymph nodes in the neck, underarm, groin, or stomach.
  • Fever for no known reason.
  • Drenching night sweats.
  • Feeling very tired.
  • Weight loss for no known reason.
  • Skin rash or itchy skin.
  • Pain in the chest, abdomen, or bones for no known reason.

Symptoms of Waldenström macroglobulinemia depend on the part of the body affected. Most patients with Waldenström macroglobulinemia have no symptoms. Check with your doctor if you have any of the following problems:

  • Feeling very tired.
  • Headache.
  • Easy bruising or bleeding, such as nosebleeds or bleeding from the gums.
  • Vision changes, such as blurred vision or blind spots.
  • Dizziness.
  • Pain, tingling, or numbness, especially in the hands, feet, fingers, or toes.
  • Confusion.
  • Pain or a feeling of fullness below the ribs on the left side.
  • Painless lumps in the neck, underarm, stomach, or groin.
  • Weight loss for no known reason.

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Screening and Diagnosis

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Blood and urine immunoglobulin studies: A procedure in which a blood or urine sample is checked to measure the amounts of certain antibodies (immunoglobulins). In Waldenström macroglobulinemia, immunoglobulin M (IgM) and beta-2-microglobulin is measured. A higher- or lower-than-normal amount of these substances can be a sign of disease.
  • Blood viscosity test: A procedure in which a blood sample is checked to see how “thick” the blood is. In Waldenström macroglobulinemia, when the amount of monoclonal immunoglobulin M (IgM) antibody in the blood becomes very high, the blood thickens and may cause symptoms.
  • Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of cells, such as size, shape, and the presence of tumor markers on the cell surface. The cells are stained with a light-sensitive dye, placed in a fluid, and passed in a stream before a laser or other type of light. The measurements are based on how the light-sensitive dye reacts to the light. This test is used to diagnose Waldenström macroglobulinemia.
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
  • Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap. A pathologist views the cerebrospinal fluid under a microscope to look for signs of cancer.
  • Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells. One of the following types of biopsies may be done:
    • Excisional biopsy: The removal of an entire lymph node.
    • Incisional biopsy: The removal of part of a lymph node.
    • Core biopsy: The removal of part of a lymph node using a wide needle.
    • Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle.
  • Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples to be checked under a microscope for signs of disease.
  • Laparotomy: A surgical procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs are removed or tissue samples are taken and checked under a microscope for signs of disease.

If cancer is found, the following tests may be done to study the cancer cells:

  • Immunohistochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer tissue to test for certain antigens. This type of study is used to tell the difference between different types of cancer.
  • Cytogenetic analysis: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the chromosomes.
  • Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell. This process is used to diagnose specific types of leukemia and lymphoma by comparing the cancer cells to normal cells of the immune system.

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Staging

After non-Hodgkin's lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body.

The process used to find out the type of cancer and if cancer cells have spread within the lymph system or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage of the disease in order to plan treatment. The following tests and procedures may be used in the staging process:

  • Complete blood count (CBC) with differential: A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells and platelets.
    • The number and type of white blood cells.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the blood sample made up of red blood cells.
  • Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the lung, lymph nodes, and liver, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.

For pregnant women with non-Hodgkin's lymphoma, staging tests that protect the fetus from the harms of radiation are used. These include MRI, bone marrow aspiration and biopsy, lumbar puncture, and ultrasound, which do not use radiation. An ultrasound exam is a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

There are three ways that cancer spreads in the body. The three ways that cancer spreads in the body are:

  • Through tissue. Cancer invades the surrounding normal tissue.
  • Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
  • Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

Stages of adult non-Hodgkin lymphoma may include E and S as follows:

  • E: "E" stands for extranodal and means the cancer is found in an area or organ other than the lymph nodes or has spread to tissues beyond, but near, the major lymphatic areas.
  • S: "S" stands for spleen and means the cancer is found in the spleen.

The following stages are used for adult non-Hodgkin's lymphoma:

Stage I

Stage I adult non-Hodgkin's lymphoma is divided into stage I and stage IE.

  • Stage I: Cancer is found in one lymphatic area (lymph node group, tonsils and nearby tissue, thymus, or spleen).
  • Stage IE: Cancer is found in one organ or area outside the lymph nodes.

Stage II

Stage II adult non-Hodgkin's lymphoma is divided into stage II and stage IIE.

  • Stage II: Cancer is found in two or more lymph node groups either above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
  • Stage IIE: Cancer is found in one or more lymph node groups either above or below the diaphragm. Cancer is also found outside the lymph nodes in one organ
    or area on the same side of the diaphragm as the affected lymph nodes.

Stage III

Stage III adult non-Hodgkin's lymphoma is divided into stage III, stage IIIE, stage IIIS, and stage IIIE+S.

  • Stage III: Cancer is found in lymph node groups above and below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
  • Stage IIIE: Cancer is found in lymph node groups above and below the diaphragm and outside the lymph nodes in a nearby organ or area.
  • Stage IIIS: Cancer is found in lymph node groups above and below the diaphragm, and in the spleen.
  • Stage IIIE+S: Cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area, and in the spleen.

Stage IV

In stage IV adult non-Hodgkin's lymphoma, the cancer:

  • is found throughout one or more organs that are not part of a lymphatic area (lymph node group, tonsils and nearby tissue, thymus, or spleen), and may be in lymph nodes near those organs; or
  • is found in one organ that is not part of a lymphatic area and has spread to organs or lymph nodes far away from that organ; or
  • is found in the liver, bone marrow, cerebrospinal fluid (CSF), or lungs (other than cancer that has spread to the lungs from nearby areas).

Adult non-Hodgkin's lymphomas are also described based on how fast they grow and where the affected lymph nodes are in the body.

Indolent or aggressive:

  • Indolent lymphomas: These tend to grow and spread slowly and have few symptoms.
  • Aggressive lymphomas: These grow and spread quickly and have severe symptoms. Lymphoblastic lymphoma, diffuse small noncleaved cell lymphoma /Burkitt lymphoma, and mantle cell lymphoma are three types of aggressive adult non-Hodgkin's lymphoma. Aggressive lymphomas are seen more often in patients who are HIV-positive (AIDS-related lymphoma).

Contiguous or noncontiguous:

  • Contiguous lymphomas: Lymphomas in which the lymph nodes with cancer are next to each other.
  • Noncontiguous lymphomas: Lymphomas in which the lymph nodes with cancer are not next to each other, but are on the same side of the diaphragm.

There is no standard staging system for Waldenström macroglobulinemia. Talk with your doctor about treatments and clinical trials that may be right for you.

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Treatment

At Huntsman Cancer Institute (HCI), non-Hodgkin's lymphoma is treated by a team of specialists, including hematologic oncologists (doctors who specialize in cancers of the blood), medical oncologists, nurses, dietitians, social workers, and other professionals.

Different types of treatment are available for patients with non-Hodgkin's lymphoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

For pregnant women with non-Hodgkin's lymphoma, treatment is carefully chosen to protect the fetus. Treatment decisions are based on the mother’s wishes, the stage of the non-Hodgkin lymphoma, and the age of the fetus. The treatment plan may change as the symptoms, cancer, and pregnancy change. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Six types of standard treatment are used:

New treatments are being tested in cinical trials,

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells and keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

For pregnant women with non-Hodgkin lymphoma, radiation therapy should be given after delivery, if possible, to avoid any risk to the fetus. If treatment is needed right away, pregnant women may decide to continue the pregnancy and receive radiation therapy. However, lead used to shield the fetus may not protect it from scattered radiation that could possibly cause cancer in the future.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). To treat certain types of adult non-Hodgkin lymphoma that spread to the brain, CNS prophylaxis (chemotherapy given to kill cancer cells in the brain or spinal cord) may be used. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Combination chemotherapy is treatment using two or more anticancer drugs. Steroid drugs may be added, to relieve swelling and inflammation.

In pregnant women, the fetus is exposed to chemotherapy when the mother is treated, and some anticancer drugs cause birth defects. Because anticancer drugs are passed to the fetus through the mother, both must be watched closely when chemotherapy is given.

Chemotherapy uses drugs to destroy lymphoma cells. Depending on the type of lymphoma, the patient may receive a single drug or a combination of two or more drugs. Learn more about this treatment in our Introduction to Chemotherapy video:

Targeted therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy and proteasome inhibitor therapy are two types of targeted therapy used to treat adult non-Hodgkin's lymphoma.

Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies that have been joined to radioactive material are called radiolabeled monoclonal antibodies.

Proteasome inhibitor therapy blocks the action of proteasomes in cancer cells and may prevent the growth of tumors.

Plasmapheresis

If the blood becomes thick with extra antibody proteins and affects circulation, plasmapheresis is done to remove extra plasma and antibody proteins from the blood. In this procedure, blood is removed from the patient and sent through a machine that separates the plasma (the liquid part of the blood) from the blood cells. The patient's plasma contains the unneeded antibodies and is not returned to the patient. The normal blood cells are returned to the bloodstream along with donated plasma or a plasma replacement. Plasmapheresis does not keep new antibodies from forming.

Biologic therapy

Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

Interferon is a type of biologic therapy. It affects the division of cancer cells and can slow tumor growth.

Watchful waiting

Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change.

Clinical trials

This section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. For more information, also visit HCI's clinical trials website.

  • Vaccine therapy: Vaccine therapy is a type of biologic therapy. Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy. Vaccine therapy can also be a type of targeted therapy.
  • High-dose chemotherapy with stem cell transplant: High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells. Learn more from our Blood and Marrow Transplant Clinic.

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Support

When you or someone you love is diagnosed with cancer, concerns about treatments and managing side effects, hospital stays, and medical bills are common. You may also worry about caring for your family, employment, or how to continue normal daily activities.

There are several places you can go for support:

  • Your health care team can answer your questions and talk to you about your concerns. They can help you with any side effects and keep you informed of all your treatments, test results, and future doctor visits.
  • The G. Mitchell Morris Cancer Learning Center has hundreds of free brochures and more than 3,000 books, DVDs, and CDs available for checkout. You can browse the library, perform Internet research, or talk with a cancer information specialist.
  • Our Patient and Family Support Services offer emotional support and resources for coping with cancer and its impact on daily life to HCI patients and their families.
  • The Linda B. and Robert B. Wiggins Wellness-Survivorship Center offers many programs to increase the quality of life and well-being of HCI patients and their families.

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Adapted from the National Cancer Institute's Physician Data Query (PDQ®) Cancer Information Summaries
This information last updated on HCI website January 2014

*If you are interested in a trial that is currently marked *Not Open, please contact the Patient Education team at 1-888-424-2100 or patient.education@hci.utah.edu for other trial options. Enrollment is updated daily.

Forte Research Systems in partnership with Huntsman Cancer Institute

Djordje Atanackovic, M.D.

Specialties: Amyloidosis, Cancer Immunotherapy, Hematology/BMT, Myeloma, Plasma Cell Leukemia, Plasmacytoma, Tumor Immunology

Michael W. Boyer, M.D.

Locations
Huntsman Cancer Hospital (801) 585-2626
Primary Children's Hospital (801) 662-4700

Specialties: Blood and Marrow Transplantation, Hematology/BMT, Pediatric Hematology & Oncology, Stem Cell Transplant

Amie Clark, APRN, FNP

Locations
Huntsman Cancer Hospital (801) 585-6906
Huntsman Cancer Hospital (801) 587-4630

Specialties: Family Nurse Practitioner, Hematology/BMT, Oncology

Michael W. Deininger, M.D., Ph.D.

Locations
Huntsman Cancer Hospital (801) 587-4630
Huntsman Cancer Hospital (801) 585-6906

Specialties: Chronic Myeloid Leukemia, Hematology/BMT, Leukemia, Myeloproliferative Neoplasms

Andrew C. Dietz, M.D., M.S.

Specialties: Blood and Marrow Transplantation, Pediatric Hematology & Oncology

David K. Gaffney, M.D., Ph.D.

Locations
Huntsman Cancer Hospital (801) 581-2396

Specialties: Breast Cancer, Gynecologic Oncology, Lymphomas, Radiation Oncology

Martha J. Glenn, M.D.

Locations
Huntsman Cancer Hospital (801) 585-0100
Huntsman Cancer Hospital (801) 585-6906

Specialties: Chronic Lymphocytic Leukemia, Hematology/BMT, Hodgkin Lymphoma, Leukemia, Lymphomas, Lymphoproliferative Diseases, Non-Hodgkin Lymphoma, Oncology

Ahmad Halwani, M.D.

Locations
Huntsman Cancer Hospital (801) 585-2626

Specialties: Hematology/BMT, Medical Oncology

Teresa Herlevi, PA-C

Locations
Huntsman Cancer Hospital (801) 585-0303

Specialties: Hematology/BMT, Physician Assistant

Gerhard Carl Hildebrandt, Dr. med. habil, M.D., FACP

Locations
Huntsman Cancer Hospital (801) 585-6906

Specialties: Amyloidosis, Aplastic Anemia, Hematology/BMT, Immunotherapy, Leukemia, Lymphomas, Multiple Myeloma

Tibor Kovacsovics, M.D.

Locations
Huntsman Cancer Hospital (801) 585-2626
Huntsman Cancer Hospital (801) 585-2626

Specialties: Hematology/BMT

Amanda A. Langemo, M.P.A.S.

Locations
Huntsman Cancer Hospital (801) 587-4477

Specialties: Hematology/BMT, Physician Assistant

Brenda S. Mueggenborg, APRN

Locations
University Hospital (801) 585-3229

Specialties: Hematology/BMT, Nurse Practitioner

Danielle Nance, M.D.

Specialties: Hematology/BMT

J. Dane Osborn, M.D.

Specialties: Hematology/BMT

Charles J. Parker, M.D.

Locations
Huntsman Cancer Hospital (801) 585-3229
Veterans Administration Medical Center (801) 584-1272

Specialties: Hematology/BMT, Hemochromatosis, Paroxysmal Nocturnal Hemoglobinuria, Porphyria

Esteban Peña, M.D.

Specialties: Hematology/BMT

Josef T. Prchal, M.D.

Locations
Huntsman Cancer Hospital (801) 585-6906
Veterans Administration Medical Center (801) 582-1565

Specialties: Anemia, Hematology/BMT, Myeloproliferative Disorders, Oncology, Thrombocythemia

Michael Allen Pulsipher, M.D.

Locations
Huntsman Cancer Hospital (801) 585-0100
Primary Children's Hospital (801) 662-4700
Primary Children's Hospital (801) 662-4830

Specialties: Benign Hematology, Blood and Marrow Transplantation, Brain Tumors, Hematology/BMT, Leukemia, Lymphomas, Neuroblastoma, Pediatric Hematology & Oncology

Hollis A. Ricker, PA-C

Locations
Huntsman Cancer Hospital (801) 585-2626

Specialties: Hematology/BMT, Physician Assistant

George M. Rodgers, III, M.D., Ph.D.

Locations
Huntsman Cancer Hospital (801) 585-2626

Specialties: Benign Hematology, Coagulation, Hematology/BMT, Hereditary Hemorrhagic Telangiectasia

Andrea M. Schindler, APRN

Locations
Huntsman Cancer Hospital (801) 585-6906

Specialties: Hematology/BMT, Nurse Practitioner

Jaime Shahan, PA-C

Locations
Huntsman Cancer Hospital (801) 585-2626

Specialties: Hematology/BMT, Physician Assistant

Paul J. Shami, M.D.

Locations
Huntsman Cancer Hospital (801) 585-0100

Specialties: Hematology/BMT, Leukemia, Myelodysplasia, Oncology

Mary Steinbach, DNP, APRN

Locations
Huntsman Cancer Hospital (801) 587-4474

Specialties: Family Nurse Practitioner, Hematology/BMT

Deborah M. Stephens, D.O.

Specialties: Hematology/BMT

John Sweetenham, M.D., FACP, FRCP

Locations
Huntsman Cancer Hospital (801) 585-6906

Specialties: Hematology/BMT, Lymphomas

Jonathan D. Tward, M.D., Ph.D.

Locations
Huntsman Cancer Hospital (801) 581-2396
South Jordan Health Center (801) 213-4320

Specialties: Bladder Cancer, Brachytherapy, Gastrointestinal Cancers, Genitourinary Cancers, Intensity-Modulated Radiation Therapy (IMRT), Lymphomas, Penile Cancer, Prostate Cancer, Radiation Oncology, Robotic Prostatectomy, Seed Implants, Stereotactic Body Radiation Therapy (SBRT), Urologic Oncology

Renee A. Vadeboncoeur, M.S.N., APRN

Locations
Huntsman Cancer Hospital (801) 585-0100

Specialties: Family Nurse Practitioner, Hematology/BMT

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Lauren PitcherHematology Cancer Program
Care coordinator: Lauren Pitcher
Phone: 801-585-6906
E-mail: lauren.pitcher@hci.utah.edu

Did You Know?

  • An estimated 69,740 new cases of non-Hodgkin's lymphoma will be diagnosed in the United States this year.
  • There are multiple types of lymphoma cancer; others include Hodgkin's lymphoma, AIDS-related lymphoma, and primary central nervous system lymphoma.
  • Huntsman Cancer Institute refers childhood lymphoma cases to Primary Children's Hospital. This facility is recognized as one of the top children's hospitals in the United States and is located on the same medical campus as HCI, allowing our specialists to collaborate in the treatment and management of childhood cancers.
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