What is T-cell lymphoma?

Lymphoma is a type of blood cancer that usually affects white blood cells called B lymphocytes, or B cells.

More rarely, lymphoma can affect white blood cells called T cells, and some affect white blood cells called natural killer cells, or NK cells. Doctors usually class NK-cell and T-cell lymphomas as a group, separate from the more common B-cell lymphomas.

There are several types of T-cell lymphoma. Around 500 people are diagnosed in the UK each year, across all types. Individually, each type is very rare.

Here are some medical terms you may hear if you are diagnosed with a type of T-cell lymphoma:

Different types of T-cell lymphoma have different effects on the body.

ATLL can affect your T-cells in your blood (leukaemia) or your lymph nodes (lymphoma). It is caused by a virus called HTLV-1 which is common in Japan, the Caribbean and some parts of Africa.

There are four types of ATLL: acute leukaemic, lymphoma type, chronic and smouldering. Acute leukaemic and lymphoma type are fast growing, and chronic and smouldering are slower growing.

AITL affects your lymph nodes (glands) and sometimes your spleen, an organ that’s part of your lymphatic system. It may also affect other organs in your body, such as your bone marrow, where blood cells are made, or your liver.

ALCL can affect your lymph nodes, or it can be extra nodal, affecting any organ in your body.

There is a specific gene that doctors test for if they think you have ALCL. This is called anaplastic lymphoma kinase (ALK). So you may be told you have either ALK+ (positive) or ALK- (negative) ALCL.

Very rarely, breast implants can cause a type of ALCL.

There is a separate type of ALCL that affects the skin, called cutaneous ALCL. Lymphoma Action has more information about skin lymphoma.

Extranodal NK/T-cell lymphoma usually affects your nose, sinuses and the top part of your throat, but it can affect other areas such as your skin and gut.

This type of T-cell lymphoma is linked to the Epstein-Barr virus (EBV), the virus that causes glandular fever. It is rare for someone who has had glandular fever to develop lymphoma.

Some types of T-cell lymphoma affect your gut (your small or large intestine). This can be linked to coeliac disease, where gluten - the protein in wheat and barley - causes the immune system to attack its own gut cells.

Enteropathy-associated T-cell lymphoma (EATL) and monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) are types of intestinal T-cell lymphoma.

This is the most common type of T-cell lymphoma. “Not otherwise specified” means that tests have ruled out other types of T-cell lymphoma.

PTCL-NOS is usually nodal, affecting one or more lymph nodes (glands), but it can also affect organs like the spleen, liver, skin or gut.

You may get a diagnosis of follicular T-cell lymphoma or nodal peripheral lymphoma with TFH. These are specific types of T-cell lymphoma which have recently been added to the World Health Organisation’s classification of blood cancers, but are currently treated the same way as PTCL-NOS.

Generally, the prognosis for T-cell lymphoma (what is likely to happen in the future) will depend on things that are personal to you. These include:

• the type of T-cell lymphoma you have
• whether it is fast growing or slow growing (chronic)
• your age and general level of fitness
• where the lymphoma is in your body
• your test results.

Your doctor may use some of this information to work out a risk score. This helps them decide how best to treat you. They should talk through what your risk score means for you.

Remember that prognosis information varies from person to person, and things you read online may not be true for you. Speak to your hospital team about your personal prognosis. If you would like to talk through what questions to ask, contact our Support Service.