Non-Hodgkin’s Lymphoma

Non-Hodgkin’s Lymphoma

Overview

Non-Hodgkin’s Lymphoma is a type of malignancy that develops in your lymphatic system. It arises from your lymphocytes, which is a type of white blood cells. Non-Hodgkin’s Lymphoma is more common than Hodgkin’s Lymphoma, and it has many subtypes. The differentiation between its subtypes depends on the type of cells from which lymphoma arises. As a result, we have B-cell lymphomas that arise from developing B-cells, and T-cell lymphomas that arise from developing T-cells.

 Recent advances in medicine and technology make Non-Hodgkin’s Lymphoma a usually curable disease.

The lymphatic system

Our lymphatic system has hundreds of lymph nodes, found almost everywhere in the body, that help us fight against various infections. The largest lymph organ in our body is the spleen, which acts as a blood filter and storage that fights against infection, when necessary. Our lymph nodes are small structures that make sure to keep the lymph clean of debris and cells. Our lymphatic system consists of the tonsils, adenoids, spleen, and thymus. Our lymphatic system is active and may suffer from various diseases, such as lymphomas. 

How common is Non-Hodgkin’s Lymphoma?

Non-Hodgkin’s Lymphoma is one of the most common types of cancers in the US. It accounts for almost 4% of all cancers. The disease will affect an estimated 77,240 people in 2020 in the US. Also, it will kill about 19,940 people in the same year. It can affect individuals from all age groups, including children and adolescents. Non-Hodgkin’s Lymphoma is slightly more common in women than in men. The overall five-year survival rate for people with Non-Hodgkin’s Lymphoma is 71%. The overall 10-year survival rate is 60%. In the presence of distant metastases, the five-year survival rate drops to 61.6%.

What is the cause of Non-Hodgkin’s Lymphoma?

As in most cases, scientists don’t know what exactly causes Non-Hodgkin’s Lymphoma. Mutations or changes in the DNA of some cells might be responsible. What doctors are certain of is that Non-Hodgkin’s Lymphoma results from a weakened immune system and follows the production of an excess number of lymphocytes. Non-Hodgkin’s Lymphoma can begin in the B or the T lymphocytes.

Risk factors of Non-Hodgkin’s Lymphoma

Risk factors increase an individual’s chance of developing a disease. The following are some of the most well-established risk factors for Non-Hodgkin’s Lymphoma:

  • Immunosuppressants. Immunosuppressant drugs may increase your chance of developing Non-Hodgkin’s Lymphoma because they reduce your immune system’s ability to fight infections.
  • Viruses and bacteria. HIV and Epstein-Barr viruses, as well as Helicobacter pylori, may increase your risk for Non-Hodgkin’s Lymphoma.
  • Chemicals. Certain chemicals raise your chances of developing Non-Hodgkin’s Lymphoma in the future.
  • Older age. Non-Hodgkin’s lymphoma can affect all age groups. However, the risk increases with age and is maximum in people sixty years old or more.

Symptoms and signs of Non-Hodgkin’s Lymphoma

The following are some signs and symptoms of non-Hodgkin’s lymphoma:

  • Swollen lymph nodes in your neck, armpits or groin that is painless
  • Abdominal pain
  • Abdominal swelling
  • Chest pain
  • Coughing or dyspnea
  • Persistent fatigue that doesn’t go away with rest
  • Fever and night sweats
  • Losing weight without trying

Types of Non-Hodgkin’s Lymphoma

Knowing the type of Non-Hodgkin’s Lymphoma is essential for its management and treatment. To identify the type of cancer cells involved in a lymphoma, doctors perform a biopsy and look at the sample tissue under the microscope. The following are the five main types of Non-Hodgkin’s Lymphoma:

  1. Chronic lymphocytic leukemia
  2. Cutaneous B-cell lymphoma
  3. Cutaneous T-cell lymphoma
  4. Follicular lymphoma
  5. Waldenstrom macroglobulinemia

Diagnosis of Non-Hodgkin’s Lymphoma

To diagnose Non-Hodgkin’s Lymphoma, your doctor will take your medical history and ask some questions regarding your lifestyle and risk factors. Afterward, he or she will perform a physical examination, along with palpation to your lymph nodes. A full blood count is also necessary. You might also need a lymph node biopsy and a bone marrow test. Finally, imaging tests might help your doctor stage the disease and establish whether there are any metastases. The stages of Non-Hodgkin’s Lymphoma are the following:

  • Stage I. The cancer is in one lymph node region.
  • Stage II. The cancer is in two lymph node regions, or it invaded one organ and the nearby lymph nodes. However, cancer is either below or above the diaphragm.
  • Stage III. Cancer is both above and below the diaphragm.
  • Stage IV. There are distant metastases to various other organs.

The following are some of the most well-used imaging tests to diagnose Non-Hodgkin’s Lymphoma:

  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • X-ray

What is the treatment of Non-Hodgkin’s Lymphoma?

To choose the correct treatment method, your doctor has to review your general characteristics, such as your age and the presence or absence of other illnesses. Another significant factor regarding treatment is the stage of your lymphoma. In some cases, treatment is not necessary at all. Options for Non-Hodgkin’s Lymphoma may be one or a combination of the following:

  • Chemotherapy
  • Radiation therapy
  • Bone marrow transplant
  • Biological therapy
  • Radioimmunotherapy

Keep in mind that most therapeutic options have side effects, which you can discuss with your doctor before initiating any therapy regiment. For example, chemotherapy may result in hair loss, fatigue, easy bruising, nausea, vomiting, and constipation. Common side effects of radiation therapy are skin conditions, fatigue, or other long-term side effects, such as the development of second cancer. Bone marrow transplantation may also have side effects, depending on the source of the transplant. Discussing all this information with your doctor is crucial before commencing any treatment.

References
https://www.mayoclinic.org/diseases-conditions/non-hodgkins-lymphoma/diagnosis-treatment/drc-20375685
https://www.cancer.org/cancer/non-hodgkin-lymphoma/about/key-statistics.html

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