Non-Hodgkin's Lymphomas

Non-Hodgkin's lymphoma occurs when cells dividing in the lymphatic system grow at an accelerated, disorganized rate. Because lymphatic vessels branch throughout the body, non-Hodgkin's lymphoma can arise anywhere and spread to organs like the liver, bone marrow and spleen.

Risk Factors

  • Men are at a slightly greater risk than women
  • Advanced age
  • A weakened immune system due to HIV
  • Autoimmune diseases
  • Immunosuppressant drugs after organ transplants
  • Inherited immune deficiencies
  • Exposure to some chemicals like fertilizers, pesticides or solvents
  • A history of certain viruses may precede non-Hodgkin's lymphoma

Symptoms

Those who suffer from non-Hodgkins lymphomas may experience a combination of the following symptoms:

  • Painless swelling in the neck, underarms or groin
  • Fever
  • Night sweats
  • Weight loss
  • Itchiness
  • Red patches on the skin
  • Constant fatigue

Detection and Diagnosis

If a patient has a number of symptoms or risk factors, the following tests may be performed. X-rays, CAT scans, magnetic resonance imaging (MRIs), and PET scansare used by physicians to detect cancerous growth.

X-rays take pictures of the inside of the body with high-energy radiation. CAT scans take more detailed pictures of the inside of the body with an x-ray machine linked to a computer.

MRI's also take detailed pictures, but with a powerful magnet linked to a computer.

To make a diagnosis, a pathologist must perform a biopsy, or examine a piece of tissue removed by a surgeon from one of the patient's lymph nodes under a microscope.

To determine what stage the lymphoma is in, the physician can use any of the above tests, or order further biopsies of other lymph nodes, the liver, bone marrow or other tissue.

Treatment Options

Treatment depends on the patient's individual case, but chemotherapy and radiation therapy are the most common treatments. Bone marrow transplant, surgery, and immunotherapy (treatment to empower the immune system to fight disease) also are options. Talk to your doctor about the best possible treatment options for your specific case.

Chemotherapy for non-Hodgkin's lymphoma involves either taking anticancer drugs by mouth or the injection of anticancer drugs into a vein. As a systemic treatment, the drugs circulate throughout the body, killing all rapidly growing cells, thus noncancerous cells can be killed as well. Side effects vary by type of drug but in general hair loss, nausea, vomiting, diarrhea, loss of appetite, sores on the mouth and the lips and a lower resistance to infection are expected.

Radiation therapy kills cancer cells with intense x-rays aimed only at the cancerous growth. Side effects from radiation therapy commonly include hair loss and skin irritations in the targeted area and fatigue. Radiation to the abdomen may result in temporary upset stomach or diarrhea, while radiation to the chest may cause lung damage, swallowing and breathing problems. Brain radiation therapy can lead to cognitive difficulties.

Bone marrow transplantation or hematologic stem cell transplantation is a procedure most commonly used for relapsed and recurrent lymphomas. This procedure supplies the patient with stem cells, which are cells that can develop into other types of cells. The stem cells replace those that have been damaged by other treatments. Stem cells can be transplanted from either person or patient. The cells have been removed and frozen. Risk of infection is high immediately following bone marrow transplantation.

In autologous BMT/HSCT, the patient serves as his own donor. Most often the stem cells are collected from the blood, where they have been 'tricked' to leave the bone marrow, where they usually reside. They are processed and frozen. After the patient receives high-dose chemotherapy, with or without radiation, they are given back their thawed stem cells as blood transfusion. These cells will replace the previously destroyed calls and allow the body to recover much faster.

In allogeneic, cells for a fully matched donor (usually a sibling), are given after high-dose chemo/radio therapy. This approach can be complicated by rejection called graft-versus-host disease. Transplants between identical twins (syngeneic) does not carry this risk.

Biological therapies make use of products of the body's own immune system. In a healthy person antibodies fight infection. Laboratory-made antibodies can fulfill the same function. Man-made monoclonal antibodies are designed to treat only lymphoma cells. Interferon, a protein usually generated by white blood cells, is known to shrink or stop the growth of lymphoma.

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