An Overview of Lymphoma

drkmh An Overview of Lymphoma

 

There are several risk factors associated with an increased likelihood of developing lymphoma including age, gender, environmental factors and family history.

Lymphoma is a type of cancer that originates in the lymphatic system, which is a vital part of the body’s immune system. The lymphatic system includes lymph nodes, lymphatic vessels, and various organs like the spleen, thymus, and tonsils. It plays a crucial role in filtering and transporting lymph, a clear fluid holding white blood cells, throughout the body.

 

Lymphoma occurs when there is an abnormal growth of lymphocytes, a type of white blood cell, within the lymphatic system. These abnormal lymphocytes can form tumours in lymph nodes or other lymphatic tissues, disrupting the normal functioning of the immune system.

 

Let us look at five basic facts about Lymphoma:

 

#1 Types of Lymphoma

 

There are two main categories of lymphoma:

 

  • Hodgkin Lymphoma (HL):

    Named after Dr. Thomas Hodgkin, this type is characterized by the presence of Reed-Sternberg cells, large abnormal cells that are specific to this subtype. HL usually starts in a single lymph node and can spread to adjacent lymph nodes. It accounts for a minority of lymphoma cases.

  • Non-Hodgkin Lymphoma (NHL):

    This is a more common and diverse group of lymphomas. There are many subtypes of NHL, each originating from different types of lymphocytes. NHL can arise in lymph nodes or other lymphatic tissues and has a wider range of behaviour and treatment approaches than HL

#2 Symptoms of Lymphoma

 

Common symptoms include swollen lymph nodes, fever, night sweats, unexplained weight loss, fatigue, and itching. Symptoms vary depending on the type and stage of lymphoma. Diagnosis of lymphoma involves physical exams, imaging tests (CT, PET scans), and biopsies of affected lymph nodes or tissues to figure out the type and extent of lymphoma.

 

#3 Lymphoma Treatment

 

Treatment options for lymphoma depend on the specific type, stage, and individual factors of the disease. Common approaches include chemotherapy, radiation therapy, targeted therapy, immunotherapy, and stem cell transplantation.

 

  • Chemotherapy: This involves using powerful drugs to kill or control cancer cells. It’s a standard treatment for many lymphomas and can be given orally or intravenously.
  • Radiation Therapy: High-energy rays are used to target and destroy cancer cells. It’s particularly effective for localized lymphomas or to shrink tumours before other treatments.
  • Targeted Therapy: These drugs are designed to target specific molecules involved in cancer growth, minimizing damage to healthy cells. Monoclonal antibodies and other targeted drugs are often used to treat certain types of lymphoma.
  • Immunotherapy: This approach boosts the body’s immune system to fight cancer cells. Examples include checkpoint inhibitors and CAR T-cell therapy, which change the patient’s own immune cells to recognize and attack lymphoma cells.
  • Stem Cell Transplantation: In cases of aggressive lymphomas or relapses, stem cells (either from the patient or a donor) are used to replace damaged bone marrow. This allows for higher doses of chemotherapy or radiation to be given.

A combination of these approaches may be used for the best possible outcome, often in coordination with a multidisciplinary medical team.

 

#4 Risk Factors for Lymphoma

 

There are several risk factors associated with an increased likelihood of developing lymphoma:

 

Age: Lymphoma can occur at any age, but the risk increases with age. Certain subtypes, like Hodgkin lymphoma, have a higher incidence among young adults, while non-Hodgkin lymphoma becomes more common as people get older.

 

Gender: Some lymphoma subtypes show a slight gender predisposition. For example, Hodgkin lymphoma is slightly more common in males, while certain non-Hodgkin lymphomas may have a higher incidence in females.

 

Weakened Immune System: People with compromised immune systems, such as those with HIV/AIDS, organ transplant recipients, and individuals on immunosuppressive drugs, have an elevated risk of lymphoma.

 

Infections: Certain infections are associated with an increased risk of lymphoma. For instance, the Epstein-Barr virus (EBV) is linked to Hodgkin lymphoma and some non-Hodgkin lymphomas. Helicobacter pylori infection is associated with a type of stomach lymphoma (MALT lymphoma).

 

Family History: Having a first-degree relative (parent, sibling, child) with lymphoma may increase the risk, although the overall familial risk is still relatively low.

 

Environmental Factors: Exposure to certain chemicals, pesticides, and herbicides has been suggested as a potential risk factor, particularly in certain subtypes of non-Hodgkin lymphoma.

 

#5 Survival Rate

Hodgkin lymphoma has high cure rates, even in advanced stages. For early-stage Hodgkin lymphoma, the five-year survival rate can be around 90% or higher. For more advanced stages, it can range from 80% to 90% or lower.

 

Non-Hodgkin lymphoma is a diverse group of diseases, and survival rates vary widely depending on the subtype. Some slow growing (indolent) subtypes have higher survival rates, with some patients living many years with the disease. Aggressive subtypes may have lower survival rates, particularly if diagnosed at an advanced stage.

 

Here are ten lesser-known facts about Lymphoma.

 

  • #1 Geographical Variation: Lymphoma rates can vary geographically. For instance, Burkitt lymphoma is more common in equatorial Africa, while T-cell lymphomas are more prevalent in East Asia.
  • #2 Link to Autoimmune Diseases: Some types of non-Hodgkin lymphoma are associated with autoimmune diseases like Sjögren’s syndrome, lupus, and celiac disease, suggesting a complex interplay between immune dysregulation and lymphoma development.
  • #3 Lymphoma and Pregnancy: Lymphoma can occur during pregnancy, presenting unique challenges for diagnosis and treatment due to the need to consider both the mother and baby’s well-being.
  • #4 Veterans and Lymphoma: Certain veterans, particularly those exposed to herbicides like Agent Orange during the Vietnam War, have a higher risk of developing lymphoma.
  • #5 Feline Lymphoma: Cats can also develop lymphoma, and it’s one of the most common types of cancer in domestic cats. Feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) are risk factors.
  • #6 Waldenström Macroglobulinemia: This rare subtype of non-Hodgkin lymphoma involves abnormal production of immunoglobulin M (IgM) antibodies, leading to a thickening of the blood’s viscosity.
  • #7 Primary Central Nervous System Lymphoma (PCNSL): PCNSL is a rare type of lymphoma that primarily affects the brain and spinal cord. It’s more common in people with compromised immune systems.
  • #8 Lymphoma in Children: While rare, lymphoma can also affect children. Paediatric lymphomas include both Hodgkin and non-Hodgkin types, each with unique characteristics and treatment approaches.
  • #9 MALT Lymphoma: Mucosa-associated lymphoid tissue (MALT) lymphoma can arise in various tissues, such as the stomach, lungs, and thyroid, and is often linked to chronic inflammation or infections.
  • #10 Follicular Lymphoma’s Indolent Nature: Follicular lymphoma is known for its indolent (slow growing) behaviour. While it may not require immediate treatment, careful monitoring is essential to ensure prompt intervention if necessary. There is no widely recommended general screening test for lymphoma that is comparable to, for example, mammograms for breast cancer or colonoscopies for colorectal cancer. This is because lymphoma encompasses a diverse group of cancers with varying subtypes and behaviours, making a single screening approach challenging. People with certain risk factors, such as a family history of lymphoma or known genetic mutations associated with increased risk or a compromised immune system, must watch out for lymphoma symptoms. Getting diagnosed earlier improves chances for survival, greatly.

Prof. Consultant - Medical Oncologist at Dr.Kamakshi Memorial Hospitals
Reviewed By:

DR.K.V.S.LATHA

PROF. CONSULTANT – MEDICAL ONCOLOGIST

MBBS., MD (INTERNAL MEDICINE)., DM (MEDICAL ONCOLOGY).