What is Lymphoma?

    Lymphoma is a form of blood cancer characterized by the uncontrolled growth of white blood cells called lymphocytes.

    These lymphocytes play a vital role in the immune system, defending the body against infections. They circulate in a fluid called lymph within the lymphatic system, which includes lymph nodes distributed throughout the body. Because of this, medical professionals often classify lymphoma as cancer affecting the immune system.

What are the types of Lymphoma?

    There are two primary types of lymphoma: Hodgkin and non-Hodgkin lymphoma, each with various subtypes.

  • Non-Hodgkin Lymphoma:
  • Non-Hodgkin lymphoma, the more prevalent type, typically originates from B and T lymphocytes within lymph nodes or tissues throughout the body. Tumour growth in non-Hodgkin lymphoma may not involve all lymph nodes, often affecting some while sparing others.

  • Hodgkin Lymphoma:
  • Hodgkin lymphoma is characterized by Reed-Sternberg cells, which are unusually large B lymphocytes. In individuals with Hodgkin lymphoma, the cancer typically spreads from one lymph node to an adjacent one.

What are the causes of Lymphoma?

    Lymphoma arises when the white blood cells in the lymphatic system undergo mutations, transforming into rapidly proliferating cancer cells that evade natural cell death. Like many cancers, most genetic mutations leading to lymphoma occur spontaneously, lacking a discernible cause. However, certain conditions or factors may elevate the risk of developing lymphoma:

  • History of viral infections such as HIV (human immunodeficiency virus), Epstein-Barr virus (causing mononucleosis), and Kaposi sarcoma-associated herpesvirus.
  • Family history of lymphoma.
  • Weakened immune system due to other medical conditions or treatments. For instance, individuals undergoing organ transplants often receive immunosuppressant drugs to prevent organ rejection.
  • Presence of an autoimmune disease, wherein the immune system mistakenly attacks the body's tissues instead of safeguarding them.

What are the risk factors of Lymphoma?

    Various risk factors can elevate the likelihood of developing both types of lymphoma.

  • Non-Hodgkin lymphoma
  • Risk factors associated with non-Hodgkin lymphoma include:

    1. Age: Predominantly affecting individuals aged 60 and older, although specific types may occur more frequently in younger age groups.

    2. Gender: Certain subtypes exhibit a higher incidence in women. In contrast, others pose a greater risk in men.

    3. Ethnicity and geographical location: Non-Hodgkin lymphoma is more prevalent in developed nations and among white populations, with lower incidences among African American and Asian American individuals in the U.S.

    4. Exposure to chemicals and radiation: Nuclear radiation and certain agricultural chemicals have been linked to an increased risk.

    5. Immunodeficiency: Individuals with compromised immune function, such as organ transplant recipients taking immunosuppressive medications or those with HIV, face a heightened risk.

    6. Autoimmune diseases: Conditions like rheumatoid arthritis and celiac disease, where the immune system targets the body's cells, may increase susceptibility.

    7. Infections: Viral and bacterial infections, including Epstein-Barr virus (EBV), known for causing glandular fever, can transform lymphocytes and elevate the risk.

    8. Breast implants: Anaplastic large cell lymphoma in breast tissue has been associated with breast implants.

    9. Body weight and diet: While overweight and obesity may play a role in lymphoma development, further research is required to establish a definitive link.

    - Hodgkin lymphoma

    Factors contributing to the risk of Hodgkin lymphoma include:

    1. Infectious mononucleosis: Epstein-Barr virus (EBV) infection, leading to mononucleosis, heightens the risk of lymphoma.

    2. Age: Individuals aged 20–30 and those aged 55 years and above face an elevated risk.

    3. Gender: Hodgkin lymphoma is slightly more prevalent in males than females.

    4. Family history: A slightly increased risk is observed in individuals with a sibling affected by Hodgkin lymphoma, particularly in identical twins.

    5. HIV infection: HIV weakens the immune system, increasing susceptibility to lymphoma.

What are the symptoms of Lymphoma?

    Symptoms of lymphoma can manifest as follows:

    1. Swelling of lymph nodes in the neck, armpits, or groin, typically painless

    2. Chronic fatigue

    3. Fever

    4. Night sweats

    5. Difficulty breathing

    6. Unexplained weight loss

    7. Pruritus (itchy skin):

How is Lymphoma diagnosed?

    Healthcare providers diagnose lymphoma through physical examinations to assess symptoms and biopsies to obtain tissue for analysis. If initial tests indicate lymphoma, additional blood and imaging tests may be conducted to gather more information and plan treatment.

    Blood tests may include a complete blood count (CBC) with differential to analyse various white blood cell types, erythrocyte sedimentation rate (ESR) to detect inflammation, lactate dehydrogenase (LDH) to assess cell turnover and liver and kidney function tests. Serum protein electrophoresis (SPEP) may also be performed to evaluate abnormal proteins produced by plasma cells.

    Imaging tests such as computed tomography (CT) scans identify signs of lymphoma, such as enlarged lymph nodes or organs. Positron emission tomography (PET) scans can detect cancerous signs, often combined with low-resolution CT or magnetic resonance imaging (MRI) scans.

    For non-Hodgkin lymphoma, additional laboratory tests may be ordered to identify unique genes, proteins, and substances associated with specific types of the disease.

What is the treatment of Lymphoma?

    Treatment approaches for lymphoma vary depending on the subtype and individual factors. For instance, healthcare providers may suggest active surveillance for slow-growing lymphomas, closely monitoring the condition before initiating treatment. Treatment options may include:

  • Chemotherapy
  • Radiation therapy
  • Targeted therapy
  • Immunotherapy
  • CAR T-cell therapy
  • Stem cell (bone marrow) transplantation

    Additionally, palliative care may be incorporated into the treatment plan to address symptoms and side effects, providing support through medication, stress management activities, and emotional and spiritual assistance.

When to see the doctor:

    Schedule a consultation with your healthcare provider if you experience any ongoing signs or symptoms that concern you.

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