What are the common complications associated with Non-Hodgkin Lymphoma that I should monitor for in my patients?

Common complications associated with Non-Hodgkin Lymphoma (NHL) that should be monitored in patients include:

• Transformation to high-grade lymphoma: Patients with low-grade NHL may experience transformation to a more aggressive high-grade lymphoma, which requires careful monitoring and patient education about symptom changes ¹.
• Relapse or disease progression: After treatment, patients are at risk of relapse, so regular clinical assessment is recommended, especially within the first 3 years post-treatment ¹.
• Late effects of treatment: These can include secondary malignancies, organ toxicities, and other long-term complications related to chemotherapy, radiotherapy, or stem cell transplantation. Patients should be provided with information on recognizing late effects and have surveillance transitioned to nurse-led or GP-led services after 3 years ¹.
• Infections: Due to immunosuppression from the disease and its treatment, patients are at increased risk of infections, including opportunistic infections ¹.
• Bone marrow suppression: Treatment can cause cytopenias, necessitating monitoring of blood counts ¹.
• Complications related to stem cell transplantation: For those undergoing autologous or allogeneic stem cell transplantation, risks include graft-versus-host disease and transplant-related toxicities ¹.

Monitoring should also include vigilance for symptoms such as unexplained lymphadenopathy, systemic symptoms (fever, night sweats, weight loss), and new or worsening symptoms that may indicate relapse or complications ².