Lymphoblastic lymphoma (LL)

What is lymphoblastic lymphoma?

Lymphoblastic lymphoma (LL) is a rare type of fast-growing non-Hodgkin lymphoma (NHL). LL develops when white blood cells called lymphocytes become abnormal (cancerous). Lymphocytes normally help fight infection.

LL can develop from both B-cell and T-cell lymphocytes. The abnormal lymphocytes (lymphoma cells) usually build up in llymph nodes, but they can affect other parts of the body.

LL is very similar to acute lymphoblastic leukaemia (ALL) and is treated in the same way. It is very rare in adults. It usually occurs in people under the age of 35. It is more common in men than women.

Symptoms of lymphoblastic lymphoma

Painless swelling in the neck, armpit or groin

Painless swelling in the neck, armpit or groin is often the first sign of lymphoblastic lymphoma (LL). It is caused by lymphoma cells building up in the lymph nodes, which makes them bigger. LL can also cause a mass or tumour in the area between the lungs (mediastinum). This can cause symptoms such as:

shortness of breath
cough
chest pain.

B symptoms

Some people also have symptoms that doctors call B symptoms. These can include:

drenching night sweats which require a change of nightwear and bed covers
high temperatures (fevers) with no obvious cause
unexplained weight loss.

Knowing if you have any B symptoms will help your doctor to stage the lymphoma and plan your treatment.

Other symptoms

LL may also affect parts of the body outside the lymph nodes. This is called extranodal disease. Symptoms depend on the area affected.

General symptoms of LL may include loss of appetite and tiredness.

Causes of lymphoblastic lymphoma

The causes of LL are mostly unknown.

Like other cancers, LL is not infectious. It cannot be passed on to other people.

We have more information about causes and risk factors for non-Hodgkin lymphoma.

Diagnosis of lymphoblastic lymphoma

The most common test for diagnosing lymphoma is a biopsy. A doctor will take a sample of tissue from the affected area. The most common place to take a biopsy from is an enlarged lymph node. This is called a lymph node biopsy). You may have all or a part of the lymph node removed. The tissue will be sent to a laboratory for testing. You may also have biopsies taken from other areas of your body.

You can read more about further tests you may have in our information about non-Hodgkin lymphoma.

Waiting for test results can be a difficult. You may find it helpful to talk to your family, friends or specialist nurse.

The stages and grades of lymphoblastic lymphoma

Your test results will help your doctors find out how many areas of your body are affected by lymphoma and where these areas are. This is called staging.

Lymphomas are also grouped as either low-grade or high-grade. Low-grade lymphomas are usually slow growing and high-grade lymphomas grow more quickly. Lymphoblastic lymphoma (LL) is a high-grade lymphoma.

Knowing the stage and grade of the lymphoma often helps your doctor plan the right treatment for you. But with LL, these factors do not affect your treatment plan.

We have more information about the stages and grades of non-Hodgkin lymphoma.

Treatment for lymphoblastic lymphoma

A team of specialists will meet to discuss the best possible treatment for you. They are called a multidisciplinary team (MDT).

Your doctor, cancer specialist or nurse will explain the different treatments and their side effects to you. They will also talk to you about things to consider when making treatment decisions.

Treatment depends on the stage of the lymphoma and whether you have symptoms that are causing problems. You may have some treatments as part of a clinical trial.

The most common treatments are:

Chemotherapy

Usually several phases of treatment are given, using different combinations of chemotherapy drugs. Lymphoblastic lymphoma (LL) is treated with the same type of chemotherapy as acute lymphoblastic leukaemia (ALL).
Steroids

Steroids are drugs that are often given with chemotherapy to treat lymphomas. They help make chemotherapy more effective.
Targeted therapy

Targeted therapies are drugs that use unique features of the cancer to find and treat cancer cells. They may sometimes be used to treat LL.
Radiotherapy

Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to nearby healthy cells. It may be used to treat lymphoma in the chest or brain. It is sometimes given to reduce the risk of lymphoma spreading to the brain.
Stem cell transplants
A stem cell transplant is sometimes used after chemotherapy. It may also used be to treat lymphoma that has come back after treatment. It is an intensive treatment, so it is not suitable for everyone. You may have a transplant using:

your own stem cells (autologous stem cell transplant)

cells from a donor (allogeneic stem cell transplant).

After treatment for lymphoblastic lymphoma

You will have regular follow-up appointments after your treatment. You can talk to your doctor or nurse about any concerns you may have at these appointments. Your doctor will want to know how you are feeling, and to check you are recovering from any side effects of treatment.

Late effects

Sometimes side effects may continue or develop months or years after treatment. These are called late effects. We have more information about long-term and late effects of treatment for lymphoma.

Sex life and fertility

Cancer and its treatment can sometimes affect your sex life. There ways to improve your sexual well-being and to manage any problems.

Treatment for lymphoma may affect your fertility. If you are worried about your fertility it is important to talk with your doctor before you start treatment. We have more information about:

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

Getting support

Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our non-Hodgkin lymphoma forum to talk with people who have been affected by non-Hodgkin lymphoma (NHL), share your experience, and ask an expert your questions.

The organisations below also offer information and support:

Blood Cancer UK

Blood Cancer UK offers support and information to people affected by blood cancers, including lymphoma.
Lymphoma Action

Lymphoma Action gives emotional support, advice and information for people with Hodgkin lymphoma or non-Hodgkin lymphoma and those close to them. It has a national network of people with lymphoma, as well as local groups. Their website has a section called trialslink where you can see information about lymphoma clinical trials.

About our information

References

Below is a sample of the sources used in our lymphoblastic lymphoma (LL) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

Gokbuget N and Hoelzer. Treatment of Lymphoblastic Lymphoma in Adults. Acute Leukemias. pp 203-214. Available from: https://link.springer.com/content/pdf/10.1007%2F978-3-540-72304-2_16.pdf

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.