Definition and Overview

A lymphoma is a tumour that forms when lymphocytes (a type of white blood cell) start to grow and reproduce abnormally. Benign (non-cancerous) lymphomas do not spread to other parts of the body. Thus, they are less serious and can easily be treated. However, they can grow and cause pain or discomfort when they press on surrounding tissue.

Malignant lymphomas, on the other hand, occur when B or T cells grow and multiply uncontrollably. They can spread to other parts of the body. Malignant lymphomas have two main types, namely Hodgkin (also known as Hodgkin’s) and non-Hodgkin (also known as non-Hodgkin’s). The main difference between the two is the involvement of an abnormal cell called Reed-Sternberg. If a patient with a malignant lymphoma has it, the diagnosis is Hodgkin’s lymphoma. Otherwise, it is non-Hodgkin’s lymphoma.

Causes of Condition

Scientists are not sure what causes ML to occur. However, they have identified factors that can increase one’s risk of the condition. It is important to note that having any of the risk factors does not mean a person will develop the disease. However, they are often seen in people with malignant lymphomas. These factors are the following:

  • A weakened or compromised immune system - The immune system protects the body against microbes or pathogens. But in some cases, it fails to work as well as it should. It can weaken due to certain medical conditions and medications.

  • Human immunodeficiency virus (HIV infection) - Based on studies, a person with HIV is up to 20 times more likely to develop a lymphoma than someone without HIV. This virus destroys a specific type of T cell and prevents other cells of the immune system from working properly. Because of this, the patient’s immune system becomes less effective in fighting infections.

  • Previous cancer treatments - Genes of lymphocytes can be damaged by radiotherapy and chemotherapy.

Other risk factors include smoking, exposure to industrial chemicals, and obesity.

Key Symptoms

Many patients are symptom-free in the early stages. The first sign of malignant lymphomas are swollen lymph nodes, which form when abnormal cells collect in certain areas of the body. The swollen lymph nodes can be found on the neck, under the arm, and groin. They can also be found in the abdomen and upper chest area. If lymphomas grow in the bowel or abdomen, patients may also present with nausea and swelling as well as vomiting, diarrhoea, and abdominal pain. However, it is important to note that swollen lymph nodes can also be caused by other less serious medical conditions.

Other symptoms are not specific to malignant lymphomas. These include feeling tired all the time, night sweats, and fever. Shortness of breath and an itchy rash are also common. Patients must consult their doctor if their symptoms do not go away with standard treatments.

Who to See and Types of Treatments Available

Malignant lymphomas are treated by cancer specialists (oncologists). Blood tests and a lymph node biopsy are used to diagnose the condition. In the majority of cases, it is treated with a combination of the following:

  • Chemotherapy - Chemotherapy uses drugs that kill cancer cells by cutting their food source. Although proven effective in many cases, it can have severe adverse effects because it can also affect healthy cells. Common side effects are hair loss, nausea, and vomiting as well as fatigue and hearing impairment.

  • Radiation therapy - Radiotherapy uses high-energy rays to treat cancer. It has two types, namely external beam radiation therapy and internal radiation therapy. The former uses a machine that delivers beams of radiation onto the treatment area from outside the body. The latter, on the other hand, involves placing radioactive substances either inside the tumour or surrounding tissue.

  • Immunotherapy - Immunotherapy works by helping the immune system to become more effective in recognising and fighting cancer cells.

  • Stem cell transplant - Stem cells are very early blood cells that can transform into any type of cell. They are used in cancer treatment because of their ability to regenerate. Stem cells can be obtained from umbilical cords of newborn babies, placenta, and bone marrows of adult individuals.

  • Surgery - Surgery is rarely used to treat lymphomas. But it can be carried out to remove the spleen. This can help remove cancer cells from the body. In some cases, it is also carried out to remove tumours or for symptoms relief.

The prognosis for patients with malignant lymphomas depends on a number of factors. These include the stage of the disease, how soon the patient received treatment, and the patient’s health condition. The five-year survival rate for patients with stage 4 Hodgkin’s lymphoma is about 65%.

References:

  • Shankland, K. R., Armitage, J. O., & Hancock, B. W. (2012). Non-Hodgkin lymphoma. The Lancet, 380(9,844),848-857. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22835603

  • Werdlow, S. H., Campo, E., Pileri, S. A., Harris, N. L., Stein, H., Siebert, R., … & Jaffe, E. S. (2016, December 31). The 2016 revision of the world health organisation classification of lymphoid neoplasms. Blood, 127(20), 2375-2390. Retrieved from http://www.bloodjournal.org/content/127/20/2375?sso-checked=true

  • Ferreri AJ, Reni M, Ceresoli GL, Villa E. Therapeutic management with adriamycin-containing chemotherapy and radiotherapy of monostotic and polyostotic primary non-Hodgkin’s lymphoma of bone in adults. Cancer Invest. 1998. 16(8):554-61. [Medline].

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