Multiple myeloma and non-Hodgkin’s lymphoma are both blood cancers. They’re differentiated based on what type of cells the cancer develops in and where it develops.
Multiple myeloma forms in white blood cells called plasma cells, typically in your bone marrow.
Lymphoma also develops in cells that become blood cells. But lymphoma cells are typically found in your lymph nodes or other parts of your lymph system.
Non-Hodgkin’s lymphoma makes up about
There are about
In this article, we take a closer look at the similarities and differences between multiple myeloma and non-Hodgkin’s lymphoma.
Here’s a brief look at how multiple myeloma and non-Hodgkin’s lymphoma compare. All statistics refer to the United States.
| Myeloma | Non-Hodgkin’s lymphoma | |
| Cells involved | plasma cells | lymphocytes, a group of white blood cells that include plasma cells |
| Estimated cases in 2022 | ||
| Lifetime risk | ||
| Median age of diagnosis | ||
| Affects children? | extremely rare | about |
| 5-year relative survival |
Researchers aren’t exactly sure what causes myeloma and non-Hodgkin’s lymphoma. They develop when gene mutations in certain blood cells cause the cells to replicate uncontrollably.
A combination of environmental and genetic factors likely plays a role in the development of these cancers. Here are some of the risk factors researchers have identified for
| Non-Hodgkin’s lymphoma | Myeloma |
| male sex | male sex |
| more likely in white Americans than in African Americans or Asian Americans | African American ethnicity |
| possibly having overweight | having obesity |
| family history | family history |
| increasing age | increasing age |
| radiation exposure | radiation exposure |
| exposure to chemicals such as benzene and some herbicides | exposure to chemicals such as benzene and some herbicides |
| immunosuppression | having another plasma cell disease such as monoclonal gammopathy of undetermined significance or solitary plasmacytoma |
| autoimmune disease | — |
| some infections such as human T-cell lymphotropic virus or HIV | — |
| breast implants | — |
Does having one of these cancers increase the risk of developing a second cancer?
People with non-Hodgkin’s lymphoma are at an increased risk of developing a second cancer. They can develop any type of cancer, including myeloma.
However, the
Chemotherapy treatment can also cause changes to the DNA of the bone marrow and potentially increase the risk of second cancers.
The secondary cancers
Signs and symptoms of
| Non-Hodgkin’s lymphoma | Myeloma |
| weakness | weakness |
| loss of appetite | loss of appetite |
| shortness of breath | shortness of breath |
| severe or frequent infections | severe or frequent infections |
| easily bruising or bleeding | easily bruising or bleeding |
| unintentional weight loss | unintentional weight loss |
| dizziness | dizziness |
| enlarged lymph nodes | bone weakness |
| chills | bone fractures |
| fatigue | bone pain |
| swollen belly | extreme thirst |
| chest pain | frequent urination |
| drenching night sweats | kidney problems |
| fever | constipation |
| — | confusion |
| — | drowsiness |
| — | abdominal pain |
| — | dehydration |
Doctors start the process of diagnosing multiple myeloma and non-Hodgkin’s lymphoma by considering your medical history, family history, and symptoms.
They also perform a physical exam to screen for potential symptoms of blood cancer. For example,
After your initial screening, a doctor will likely recommend more specific tests.
Non-Hodgkin’s lymphoma
A lymph node biopsy is needed to confirm a diagnosis of non-Hodgkin’s lymphoma. This involves taking part or all of a lymph node, so its cells can be analyzed in a lab. A bone marrow biopsy may also be done.
- determine the extent of the cancer
- monitor whether treatment is working
- look for signs of the cancer returning after treatment
Imaging tests may include:
A doctor may also order supportive blood tests to help determine your overall health and how advanced your cancer is. They might order:
- a complete blood count (CBC)
- a blood chemistry test
- a lactate dehydrogenase (LDH) test
- hepatitis or HIV tests
Multiple myeloma
If your symptoms are suggestive of myeloma, a doctor might recommend the following blood chemistry tests:
- testing for high creatinine levels that suggest your kidneys aren’t working well
- testing for low albumin levels
- testing for high calcium levels
- testing for high LDH levels, which are associated with a
poorer outlook - quantitative immunoglobin blood testing to measure levels of antibodies in your blood
- serum-free light chain testing
- serum protein electrophoresis (SPEP) testing
- beta-2 microglobulin testing to look for a protein created by myeloma cells
A doctor may also recommend a urine test to look for myeloma protein.
They may also recommend analyzing a section of your bone marrow with a procedure called bone marrow aspiration and biopsy, in which a long needle is used to take a small bone marrow sample for lab analysis.
As for non-Hodgkin’s lymphoma, for myeloma, a variety of imaging tests are used to help monitor treatment and see how far cancer has spread.
Myeloma and lymphoma are treated differently. Here’s a look at the treatment options.
Multiple myeloma
Treatment for myeloma often involves a combination of
- bortezomib
- lenalidomide
- dexamethasone
If treatment doesn’t work, or if the cancer comes back, doctors will recommend a different combination.
Treatment for bone disease often includes bisphosphonates with chemotherapy, sometimes with radiation therapy. Some people may be eligible for chimeric antigen receptor (CAR) T-cell therapy after other treatments fail, although it can cause serious side effects.
Supportive treatments might include:
- antibiotics
- blood transfusions
- intravenous immunoglobulin
Non-Hodgkin’s lymphoma
Treatment for non-Hodgkin’s lymphoma may involve “watchful waiting” if the cancer develops slowly and you don’t have any serious symptoms.
Chemotherapy is usually the primary treatment for non-Hodgkin’s lymphoma. Steroids are often combined with chemotherapy to make it more effective. Chemotherapy may also be combined with biological therapy or radiation therapy.
Some types of non-Hodgkin’s lymphoma are treated with monoclonal antibodies. These medications signal to your immune system to attack cancer cells.
The relative 5-year survival rate is a measure of how many people with a cancer are alive five years after diagnosis.
Multiple myeloma
The outlook for people with myeloma is best when the cancer is caught early. Here’s a look at the relative
| Stage | Survival rate |
| Localized | 78% |
| Regional | — |
| Distant | 55% |
| All stages combined | 56% |
- earlier stage
- younger age
- good overall health
- good kidney function
Non-Hodgkin’s lymphoma
The outlook for people with non-Hodgkin’s lymphoma depends on the subtype. The overall 5-year relative survival rate is
Here’s a look at the survival rates by stage for the two most common subtypes:
| Diffuse large B-cell lymphoma | Survival rate |
| Localized | 74% |
| Regional | 73% |
| Distant | 57% |
| All stages combined | 64% |
| Follicular lymphoma | Survival rate |
| Localized | 97% |
| Regional | 91% |
| Distant | 86% |
| All stages combined | 90% |
In general, factors linked to a good outlook for people with non-Hodgkin’s lymphoma include:
- age 60 and below
- early stage cancer
- no lymphoma outside nodes
- able to perform daily activities
- normal serum LDH
Here are some frequently asked questions people have about myeloma and non-Hodgkin’s lymphoma.
Can you have multiple myeloma and lymphoma at the same time?
Although rare, some
Does multiple myeloma affect the lymph nodes?
Myeloma that starts in a lymph node is extremely rare, with only about
Which is worse, multiple myeloma or non-Hodgkin’s lymphoma?
Non-Hodgkin’s lymphoma has a higher relative 5-year survival rate overall, but people with some subtypes may have a poorer outlook.
Does multiple myeloma or non-Hodgkin’s lymphoma run in families?
Family history is a risk factor for both myeloma and non-Hodgkin’s lymphoma.
Multiple myeloma and non-Hodgkin’s lymphoma are two types of blood cancer. Non-Hodgkin’s lymphoma develops in a type of white blood cell called lymphocytes. Myeloma develops in a specific lymphocyte called plasma cells.
It’s impossible to know whether you have myeloma or lymphoma without a proper medical diagnosis. You can start the diagnosis process by visiting a medical professional.