"High-grade lymphomas are treated with chemotherapy and immunotherapy."

Overview

What is Lymphoma?

Lymphoma is a type of cancer that arises in white blood cells (lymphocytes). Lymphocytes are the cells that are required to find infection and other diseases. It is part of the immune system. Like, other cancers, these lymphocytes keep multiplying without any stop which leads to various types of lymphomas. The lymphocytes mature to various stages in the lymph nodes and are produced from the bone marrow.

The patient can present with lymph node and swelling/. Bone marrow can also get involved. All organs have a lymphatic system and on occasion, lymphoma can arise in any organ of the body.

Where does it start?

Starts in lymph nodes. Sometimes, it can be in the bone marrow and other organs.

Are lymphomas cancerous?

Yes, all Lymphomas are cancerous.

Are lymphomas curable?

The intermediate grade non- Hodgkin’s lymphomas are curable to about 40 to 60% and High grade - 80 to 90 % are curable.
Low grades – a good majority don’t need treatment. They have the option of the watch and wait. It is a slow-growing lymphoma.
If treatment is required, the disease can be controlled but the chance of relapse is high.

Types

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Lymphomas are majorly classified into 2 types.
Non-Hodgkin’s or Hodgkin’s lymphoma
The Non-Hodgkin’s can be subdivided into B or T cell type. Within the B & T cell, it could be a low grade, intermediate grant or high-grade lymphoma.
There are more than 50 types of non-Hodgkin’s lymphomas and within the 50 there are various subtypes.
Hodgkin’s lymphomas arise from the B-cell and it could be a classic or non-classic Hodgkin’s lymphoma.
The type is differenced by obtaining a biopsy, and how these cells look under the microscope and further by doing additional immune phenotyping of these cells.

Warning Signs

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Abnormal lymph node enlargement
Fever
Weight loss
Drenching night sweats
Other symptoms based on the organ involved

Causes

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Some infections will put at high risk of lymphoma eg. HIV Virus
HTLV Virus (Human T cell virus)
Hepatitis C
Helicobacter pylori
Weaker immune system
Prior history of organ transplant
Other causes could be environmental and lifestyle factors
Breast implants with a textured surface are occasionally causes

Diagnosis

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Lymphomas are diagnosed with Biopsy of the involved lymph node or the organ.

Lymphomas are staged and Imaging studies such as CT, PET CT, MRI, X-Rays and ultrasound will be required for staging.

Treatment

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The treatment for a majority of low-grade lymphomas can watch and wait.

Within this, treatment may be required for patients if the indications are full-filled.

For Intermediate lymphomas chemotherapy and immune therapy is required.

High-grade lymphomas are treated with chemotherapy and immunotherapy.

Some of the patients may need radiation therapy. If the patient relapses after the treatment, the high-risk patient would require stem cell transplantation. The majority of the time it is auto logos.

Stage of Lymphomas

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Stage 1- Cancer found in one localized non-lymph site
Stage 2- Cancer is found in two or more lymph node groups either above or below the diaphragm
Stage 3- Cancer is more disseminated and found in one or more lymph node groups above and below the diaphragm
Stage 4- cancer is found throughout one or more organs that are not part of a lymphatic area (lymph nodes, tonsils, thymus, or spleen); or, cancer is found in one organ that is not part of a lymphatic area and has spread to lymph nodes far away from that organ; or cerebrospinal fluid, the liver, bone marrow, or lungs.

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