Lymphoma

• Leukemia is a type of cancer found in your blood and bone marrow, is caused by the rapid production of abnormal white blood cells. The high number of abnormal white blood cells are not able to fight infection, and they impair the ability of the bone marrow to produce red blood cells and platelets.

• Lymphoma is a type of blood cancer that affects the lymphatic system, which removes excess fluids from your body and produces immune cells. Lymphocytes are a type of white blood cell that fight infection. Abnormal lymphocytes become lymphoma cells, which multiply and collect in your lymph nodes and other tissues. Over time, these cancerous cells impair your immune system.

• Myeloma is a cancer of the plasma cells. Plasma cells are white blood cells that produce disease- and infection-fighting antibodies in your body. Myeloma cells prevent the normal production of antibodies, leaving your body's immune system weakened and susceptible to infection.

Lymphoma is the cause of the uncontrolled growth of lymphocytes, a component of a white blood cell. It develops in the lymph nodes of the neck, armpit, diaphragm, also present in thymus, spleen2. Every year over 500,000 people are diagnosed with non Hodgkin lymphoma making this subtype one of the most common types of blood cancer.3

There are two general categories of lymphoma4

1. Hodgkin Lymphoma: It is when there is present of an abnormal white blood cell, Reed-Sternberg cell, in the lymphs.

2.  Non-Hodgkin Lymphoma (NHL): is the most common type of lymphoma, found in 4 out of 5 patients. More than 90 subtypes are present and some of the subtypes are more common than others5. Every year over 500,000 people are diagnosed with NHL. 2

Factors which contributes to rise lymphoma are:

In case of Hodgkin Lymphoma: Previous infection by Epstein-Barr virus, weakened immune system, early adulthood (15-34 years), or older patients (50years-above)

In case of Non Hodgkin Lymphoma: older patients, over the age of 60, autoimmune disease, previous chemotherapy or radiotherapy that reduced the immune system, HIV, AIDS, Coeliac disease

In case of Lymphoma, Hodgkin and Non- Hodgkin shares some common symptoms:

• Painless swelling of lymph nodes, neck, underarm, groin

• Generalized weakness

• Loss of appetite

• Weight loss

• Breathlessness

• Bone pain

• Itching

• Excessive night sweats

In many cases, the Practitioners will not be able to identify a lymphoma. So, they might refer the patients to hematologists or oncologists for further investigation. Physicians generally recommend the following tests.

• Blood Test

• Scans and X-Rays

• A Computed Tomography (CT) scan

• A Magnetic Resonance Imaging (MRI)

• An ultrasound

• Lymph Node Biopsy

• Bone Marrow Tests

It is to explain the extent of the cancer.

• Stage I: In this stage, cancer involves a single lymph node. They can be anywhere in the body, either above or below the diaphragm.

• Stage IE: lymphoma means that the lymphoma started in a single body organ outside the lymphatic system and is only in that organ. This is called extranodal lymphoma.

• StageII: Lymphoma is present in any 2 or more groups of lymph nodes but it has to be on the same side of the diaphragm.

• Stage IIE : Lymphoma started in one body organ and is also in one or more groups of lymph nodes. These must all be on the same side of the diaphragm.

• Stage III: Lymph nodes affected on both sides of the diaphragm

• Stage IV : the most advanced stage of lymphoma.Here the lymphoma had spread to lymph nodes and has spread to at least one body organ outside the lymphatic system such as, lungs, liver, bone marrow or solid bones

Sometimes letter A, B might be seen with the stage, the letters are explained below

• A- non symptoms

• B- Fever, drenching sweats, weight loss

Stages for children differs, and the Physician will be able explain it after proper examinations.

Physician will be able to give a guideline about the treatment depending on the particular subtypes of Hodgkin or non-Hodgkin Lymphoma. Surgery, radiotherapy, chemotherapy, immunotherapy, radio-immunotherapy, bone marrow transplantation, stem cell transplantation are the options from which the doctor will choose to help the patient

There is no specific way to prevent lymphoma. Avoiding the risk factors and doing regular exercise, eating nutritional food, avoid smoking, alcohol consumption is always helpful to maintain a healthy lifestyle.

Reference

1. American society of Hematology . Blood Cancer[Internet; accessed on 2019, October]. Retrieved from

2. Lymphoma Action. What is lymphoma.[Internet; cited 2019, October]. Retrieved from

3. GLOBOCAN 2018.World Fact sheet [Internet; cited 2019, October]. Retrieved from

4. Blood Wise. Lymphoma. [Internet; cited 2019, October]. Retrieved from

5. Lymphoma. Research. Foundation. What is lymphoma. [Internet; cited 2019, October]. Retrieved from

6. Cancer.Net Lymphoma - Hodgkin: Risk Factors. [Internet; cited 2019, October]. Retrieved from

7. Cancer,Net. Lymphoma - Non-Hodgkin: Risk Factors [Internet; cited 2019, October]. Retrieved from

8. Bloodwise Lymphoma symptoms and diagnosis[Internet; cited 2019, October]. Retrieved from

9. Lymphoma Action, Tests, Diagnosis and Staging [Internet; cited 2019, October]. Retrieved from

10. Lymphoma Action. Staging of Lymphoma [Internet; cited 2019, October]. Retrieved from