Overview
Non-Hodgkin’s lymphoma is a type of cancer that affects the lymphatic system. It occurs when tumours develop from the lymphocytes. It is more common than Hodgkin’s lymphoma.
The key difference between Hodgkin’s lymphoma and non-Hodgkin’s lymphoma is the presence of a type of abnormal cell called the Reed-Sternberg cell, which is seen in Hodgkin’s lymphoma. Early detection helps in treating the condition effectively.
Symptoms
Non-Hodgkin lymphomas may present different signs and symptoms, depending on the type of lymphoma and the location of its occurrence in the body. The common signs and symptoms are:
Causes
Researchers have found that non-Hodgkin’s lymphoma is generally linked to a few risk factors, but the definite causes of this condition largely remain unknown. Many people with this condition have no obvious risk factors and those with multiple risk factors never develop NHL. Some factors that may increase NHL risk include:
Age: The risk of developing non-Hodgkin’s lymphoma increases with age. Most people are aged 60 or older when diagnosed.
Immunosuppressant drugs: Prolonged usage of immunosuppressant drugs increases the risk.
Infections: Infections, particularly with HIV, Epstein-Barr virus, or Helicobacter pylori are known to increase the risk of non-Hodgkin’s lymphoma.
Harmful chemicals: Exposure to certain chemicals, such as weed and insect killers increase the risk of non-Hodgkin’s lymphoma.
Diagnosis
Medical history and physical exam: The doctor will want to get a complete medical history, including information about the patient’s symptoms, possible risk factors, and other medical conditions. The doctor will be paying special attention to the lymph nodes and other areas of the body that might be affected, including the spleen and liver.
Blood tests: Blood tests are performed to study how advanced the cancer is. For a lymphoma patient, low blood cell count indicates that cancer reached the bone marrow and is affecting its functioning.
Biopsy: Biopsy is the only way that a non-Hodgkin’s lymphoma can be confirmed. The procedure involves collecting some sample tissue from one of the abnormal lymph nodes and examining it under the microscope. This diagnostic procedure is crucial to confirm and classify the lymphoma.
Imaging tests: Imaging tests like x-rays, sound waves, magnetic fields, or radioactive particles to capture the pictures of the inside of the body. These tests help in:
- Looking for possible causes of certain symptoms (such as enlarged lymph nodes in the chest in someone having chest pain or trouble breathing)
- Determining the stage (extent) of the non-Hodgkin’s lymphoma
- Showing if treatment is working
- Looking for possible signs of lymphoma coming back after treatment
Bone scan: This test is usually done if a person is having bone pain or has lab results that suggest the lymphoma may have reached the bones.
Treatment
Treatment options depend on the: Type of non-Hodgkin’s disease Stage, size and location Patient’s age and overall health status
Chemotherapy: Chemotherapy is the main line of treatment for most people with non-Hodgkin lymphoma. Depending on the type and the stage of the lymphoma, chemotherapy may be used alone or combined with other treatments, such as immunotherapy drugs or radiation therapy. Often several drugs are combined while treating this disease.
Radiotherapy: Radiation therapy serves as the main treatment for those with stage 1 and stage 2 non-Hodgkin’s lymphoma. For more advanced lymphomas, radiation therapy is often combined with chemotherapy. Stem cell transplant candidates may also be treated with radiation therapy to ensure that all the lymphoma cells are killed. Lastly, it is also used in palliative care.
High-dose chemotherapy and Stem cell transplant: This procedure involves a course of high-dose chemotherapy followed by a transplant of stem cells. The stem cells could be removed from the patient’s blood and later transplanted back into his/her body (autologous), or the stem cells collected from another person (a donor) could be used (allogeneic).
Immunotherapy: Through immunotherapy, the body’s immune system in such a way that the body starts fighting against the cancer cells. Various mechanisms are used to achieve successful immunotherapy. Since this is a lymphatic disease, immunotherapy may show better response.
Targeted therapy: Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.
