What Andrés Galarraga's Story Can Help Us Understand About Non-Hodgkin Lymphoma

Two seasons lost, two comebacks

Andrés Galarraga, "The Big Cat," was a Venezuelan first baseman who finished with 399 major league home runs and five All-Star selections.

The Society for American Baseball Research records the medical part of his career in detail. In spring training in 1999 he was diagnosed with non-Hodgkin's lymphoma. It had settled in his lower back, on the second lumbar vertebra. He missed the entire season and had five months of chemotherapy and radiation. He returned in 2000, hit a game-winning home run in Atlanta's opening game, played 141 games, and took Comeback Player of the Year.

Then it came back. In November 2003 he was diagnosed with the same form of non-Hodgkin's lymphoma. He spent most of January 2004 at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University, where he had a stem-cell transplant along with chemotherapy and radiation again. He played his last major league game on October 3, 2004, and retired in March 2005.

That is the public record. No subtype beyond "non-Hodgkin's lymphoma" has been made public, and this page does not guess at one.

What "non-Hodgkin lymphoma" covers

Non-Hodgkin lymphoma is not one disease. NCI calls it a heterogeneous group of lymphoproliferative malignancies with different patterns of behavior and different responses to treatment.

It starts in lymphoid tissue: the lymph nodes, but also the tonsils, thymus, spleen, bone marrow, and lymph tissue scattered through other organs including the small intestine. B-cell lymphomas make up about 85% of cases.

Compared with Hodgkin lymphoma, NCI describes NHL as much less predictable, with a far greater tendency to spread to extranodal sites — meaning places outside the lymph nodes. A lymphoma found in a vertebra is one example of that pattern. Our page on Hodgkin versus non-Hodgkin lymphoma explains the split.

The division that decides everything

NCI sorts NHL into two prognostic groups, and the words are used in a specific technical sense.

Indolent lymphomas grow slowly. NCI describes a relatively good outlook, with median survival as long as 20 years, but says they are usually not curable once advanced. Early-stage indolent disease can be treated effectively with radiation alone. Most indolent NHLs look nodular, or follicular, under the microscope.

Aggressive lymphomas grow fast. NCI says the short-term outlook is worse, but that more than 70% of people with aggressive NHL can be cured with intensive combination chemotherapy.

That is the counterintuitive part. The fast-growing type is the one more often cured, because fast-dividing cells are what chemotherapy is best at killing. The slow type responds well and keeps coming back.

NCI adds that most relapses happen in the first two years after treatment, and that the risk of a late relapse is higher in people whose disease shows both indolent and aggressive features.

Staging, and what a second course involves

Lymphoma is staged I to IV under the Lugano classification. Stage I is one lymphatic site. Stage IE is a single site outside the lymph system with no node involvement. Stage II is two or more node regions on the same side of the diaphragm, and stage III crosses to both sides. Bulk matters too: in diffuse large B-cell lymphoma the recommended cutoff for calling a mass bulky is 10 cm. Our page on lymphoma stages walks through the system.

When lymphoma returns after chemotherapy, one option is a stem-cell transplant. High-dose treatment is used to clear the marrow, and blood-forming stem cells are given back to rebuild it. Our page on stem cell transplant covers what that involves.

The part that runs for decades

NCI is unusually direct about the long tail of NHL treatment.

For as long as three decades after diagnosis, people who have had NHL carry a significantly raised risk of a second primary cancer. NCI names lung, brain, kidney, and bladder cancers, melanoma, Hodgkin lymphoma, and acute nonlymphocytic leukemia.

Alkylating chemotherapy drugs can impair fertility. Doxorubicin above 200 mg/m² was linked to left ventricular dysfunction — weakening of the heart's main pumping chamber — in long-term survivors of high-grade NHL. Myelodysplastic syndrome and acute myeloid leukemia are late complications of high-dose therapy with a transplant. In one series of 605 people who had an autologous bone marrow transplant, 21% developed a second cancer over a median ten years of follow-up.

None of that argues against treatment. It argues for follow-up that does not stop after five years. Our page on late effects of cancer treatment sets out what is watched for.

The numbers

For 2026 the American Cancer Society projects 79,320 new US cases of NHL and 19,970 deaths, and SEER posts that projection beside its own measurements. The older pair of 80,350 cases and 19,390 deaths belongs to 2025, and NCI's PDQ summary still reproduces it.

SEER puts five-year relative survival across all stages, for cases diagnosed in 2016 through 2022, at 74.3%, with a median age at diagnosis of 68. By Ann Arbor stage: 87.6% for stage I, 79.7% for stage II, 74.0% for stage III, and 63.6% for stage IV. Stage IV accounts for 37% of cases, the largest single group.

These are averages across every subtype pooled together. Because the subtypes behave so differently, they describe the group far better than any individual.

When to get checked

See a clinician if any of this has run for more than two or three weeks:

• A swollen lymph node in the neck, armpit, or groin that is painless and not shrinking
• Fever above 38 degrees Celsius, or 100.4 Fahrenheit, with no infection found
• Night sweats heavy enough to soak nightclothes or bedding
• Losing 10% or more of body weight without trying
• Persistent back or bone pain, especially at night, that does not track with activity
• Itching all over with no rash

Age is not a reason to wait. Galarraga was 37 at his first diagnosis.

What this does not mean

• No subtype has been made public. Statements about indolent versus aggressive disease here describe categories, not his case.
• One person's return to elite sport is not a prediction. Subtype, stage, and response all differ.
• A swollen node is far more often an infection than a lymphoma. What matters is the one that does not settle.
• The 74.3% five-year figure pools dozens of different diseases. It is not a forecast for anyone.
• The late-effect data come from people treated with older regimens. They are a reason for long follow-up, not a reason to expect harm.

Sources

• Society for American Baseball Research, BioProject: Andres Galarraga — https://sabr.org/bioproj/person/andres-galarraga/
• NCI PDQ, B-Cell Non-Hodgkin Lymphoma Treatment (Health Professional Version) — https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq
• NCI, Lymphoma—Patient Version — https://www.cancer.gov/types/lymphoma
• SEER Cancer Stat Facts, Non-Hodgkin Lymphoma — https://seer.cancer.gov/statfacts/html/nhl.html
• American Cancer Society, Cancer Facts & Statistics — https://www.cancer.org/research/cancer-facts-statistics.html

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

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