Non-Hodgkin’s Lymphoma
Non-Hodgkin's Lymphomas (NHL) are a group of cancerous diseases that affect the Lymph system. They are called as such, in order to differentiate them from the other common form of lymphatic cancer: Hodgkin's Lymphoma.
The lymphatic system spreads throughout the whole body (glands, spleen, thymus, tonsils, bone marrow, and lymphatic vessels). The lymphocytes are cells produced by the lymphatic system that circulate around the whole body through the lymphatic vessels and the blood vessels. They are responsible for the defence of the organism against infections. In Non-Hodgkin's Lymphomas a specific lymphocyte is produced uncontrollably, over time, causing the swelling of the organ in which it is produced. Given that lymphatic tissue can be found all around the body, lymphomas can develop in any part of the organism, and from that point spread to the liver and other organs and tissues. See a video about the lymphatic glands at the Medline medical encyclopaedia.
See a video about the lymphatic glands at the Medline medical encyclopaedia
The most common lymphoma in adults is called Diffuse Large Cell Lymphoma but there are many other types (Lymphoblastic, Burkitt's, Mantle cell, follicular, splenic, lymphocytic, lymphoplasmacytoid, MALT, Sézary's or Mycosis fungoides, among others).
New cases of NHL each year read at between 30 and 70 in a million. They are more frequent among men, among patients with a disease of the immune system (Aids, immunodeficiency, organ transplant receivers, and autoimmune diseases), among patients with an infection (helicobacter gastritis, Epstein Barr virus), and patients being treated for chemotherapy or radiotherapy.
Learn about Víctor, Non-Hodgkin's lymphoma patient
First symptoms
The symptoms of the NHL's vary a lot and depend on each specific case of lymphoma. The most common are: painless swelling of the glands, fever, nocturnal sweating, loss of weight, fatigue, repeated infections. Problems can also occur due to the growth of the spleen (abdominal pains), due to the compression of an organ by a large tumor (cough, lower back or abdominal pain), or due to the poor functioning of an organ resulting from the infiltration of cancerous cells.
Study
The diagnosis of NHL is achieved by conducting a biopsy of one of the swollen glands and will be completed with a study into the extent of the disease (examinations to find out how many lymph node areas have been affected). These examinations will include a blood test, one or more image tests (radiograph, ultrasound, scintigraphy, and MRI scan) and a bone marrow biopsy (biopsy of the hip bone) to assess the condition of the bone marrow.
Microscopic image of Burkitt's Lymphoma
Microscopic image of diffuse large B-cell lymphoma
Treatment
Similar to the symptoms, the treatment of the NHL's depends largely on the type of the disease, the age and general state of the patient, and the extent and level of progression of the disease.
As a general rule, the indolent lymphomas (with a lower level malignancy) spread throughout the whole body, have a very slow evolution, which means they might not need treatment immediately at the point of diagnosis, and have a worse response to the common chemotherapies. On the other hand, the aggressive lymphomas (with a higher level malignancy) can be more localized and have a quicker evolution, which means it is necessary to treat them rapidly, but they often respond well to treatment and frequently achieve a full remission of the disease (absence of the symptoms and the disease using the methods of study discussed above) and in many cases a full cure is reached.
When treatment is required it is common to administer chemotherapy which will involve several drugs, effective against cancerous cells, administered every 3-4 weeks, with a total of 6-8 cycles. Occasionally radiotherapy is applied in conjunction with chemotherapy in order to control larger tumors.
In recent years, monoclonal antibodies have been used with increased frequency to treat patients. These agents are specifically designed to directly attack the diseased cells and they are also less harmful to the healthy cells than chemotherapy is.
In many cases these treatments are sufficient to control the disease; but in others there exists the need to introduce more intense therapies such as an autologous transplant of hematopoietic stem cells. Only in extreme cases would the need arise for an allogeneic transplant form a compatible donor.
If you would like to receive more information, you can consult the following webpages:
• Non-Hodgkin's Lymphoma, National Cancer Institute
• Non-Hodgkin's Lymphoma, Medline Plus
• Non-Hodgkin's Lymphoma, University of Bonn
• Document about Mantle cells, resource of The Leukaemia and Lymphoma Society
• Document about Cutaneous T cell Lymphoma, resource of The Leukaemia and Lymphoma Society
• Non-Hodgkin's Lymphoma, resource of The Leukaemia and Lymphoma Society
