Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. Lymphoma is a group of cancers that affect the cells that play a role in the immune system, and primarily represents cells involved in the lymphatic system of the body. The lymphatic system is a network of branching tubes that carry a fluid called lymph along with cells that play a major role in fighting disease and infection. The lymphatic system also contains small nodes that filter the lymph, which may contain bacteria or viruses. Cancer occurs when normal disease fighting cells called lymphocytes undergo a transformation in which they grow and multiply uncontrollably.
As the abnormal cells multiply, they may collect in one or more lymph nodes or in other lymph tissues. They may form a mass, or tumor, or invade neighboring tissues or distant organs. Lymphomas fall into two major categories: Hodgkin lymphoma or HL, also called Hodgkin’s disease, and all other lymphomas, also called non- Hodgkin lymphomas. These cancers may have similar symptoms but can be distinguished by examining blood or tissue samples under a microscope. Hodgkin’s disease arises from abnormal B lymphocytes, cells that produce proteins that attach to abnormal or infected cells, alerting the immune system to destroy them. Non- Hodgkin lymphoma arises from either abnormal B cells or T cells, which kill infected cells and regulate immunity. It has specific genetic markers. There are many different subtypes of lymphomas that respond differently to therapies. Hodgkin’s disease is most common in young adults ages 1. Non- Hodgkin lymphoma is more likely to occur in older people. The National Cancer Institute estimates that 6. Hodgkin's lymphoma will be diagnosed in 2. This represents 8. Unexplained weight loss: Symptom — Overview covers possible causes of unexplained weight loss.Approximately 8,0. Hodgkin lymphoma are detected per year, representing less than 1 percent of all cancers. ![]() ![]() ![]() ![]() Non- Hodgkin lymphomas characteristically are associated with abnormalities of chromosomes. The way in which these abnormalities lead to lymphomas is a major focus of investigation at the Kimmel Cancer Center. Lymphoma Experts Risk Factors. Researchers do not know the exact causes of lymphoma. Most people are diagnosed over the age of 6. People with weakened immune systems from infections such as HIV/AIDS, Epstein- Barr virus, Hepatitis C, and Helicobacter pylori may be more susceptible to lymphomas. Survivors of nuclear reactor accidents and others exposed to high levels of radiation are at an increased risk for developing non- Hodgkin lymphoma. People who had previous radiation therapy are also at a higher risk for lymphoma. Symptoms. The early symptoms of lymphoma may be minor or mimic common illness. The first sign of lymphoma may be a painless swelling in the neck, under an arm or in the groin. ![]() ![]() Even if you do everything right and are managing your diabetes well, you can still wake with unexplained blood sugar spikes. Learn the causes and what to do. Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality. The most common etiologies are malignancy, nonmalignant. If your pet loses weight quickly, you need to see a veterinarian. Unexplained sudden weight loss in cats and dogs can signify disease or some other health issue. ![]() ![]() An enlarged lymph node may cause other symptoms by pressing against a vein (swelling of an arm or leg), a nerve (pain, numbness or tingling), or the stomach (early feeling of fullness). Other symptoms include fevers, chills, unexplained weight loss, night sweats, lack of energy, chest pain, lower back pain or itching or rashes. Diagnostic Tests. Lymphoma patients referred to the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins are seen by a team of doctors who specialize in the disease. Hematologists, oncologists and pathologists examine the lymph nodes to define the specific type of lymphoma to best plan treatment. A dedicated hematologic pathology division within our medical center has extensive expertise in the development and uses state- of- the- art technologies to accurately diagnose leukemia and lymphoma. Lymphomas are diagnosed by taking a small sample of an enlarged lymph node and examining it under a microscope - - a procedure called a biopsy. Examining lymph nodes for lymphoma is best done by experienced hematopathologists - - pathologists who focus primarily on this type of disease using specialized techniques. The type of lymphoma can be identified by the physical appearance of the cancer cells under the microscope, or by using markers that identify special molecules on the lymphoma cells. Additional tests, such as blood tests, a chest X- ray or examination of bone marrow cells or tissue can help doctors see how far the disease has spread and what organs are affected. Staging Staging is a process used to determine how far the cancer has spread. It’s important for doctors to know the stage of disease so they can plan the best treatment. Most types of lymphoma are given stages of I, II, III, or IV based on the size of the tumor and how far from the original site in the body the cancer has spread. In addition, an organ not in the lymph system but close to the involved nodes may be affected. It may also involve the spleen, an organ located in the abdomen behind the ribs that removes and destroys old red blood cells and helps fight infection. Patients complaining of so- called . Those without the symptoms might have an A added to their stage. If any organ that does not belong to the lymph system is involved, the cancer stage is denoted with a letter E after the stage, for extralymphatic organ involvement. If the spleen is involved, the corresponding letter is S. Non- Hodgkin lymphoma is usually categorized into one of three grades. The treatment of non- Hodgkin lymphoma depends on the particular type of cancer. Chemotherapy is usually the main treatment, with radiation therapy or antibody or biological therapy added as necessary. Chemotherapy – A combination of three or more drugs are generally used. All or most of the drugs are administered either as quick injections or as slow infusions into your veins, though some may be taken as pills. There are a number of effective drug combinations available. Chemotherapy is typically administered every two to three weeks for a number of cycles. Side effects can depend on which drugs were given and how much, but include fatigue, hair loss, poor appetite, nausea or vomiting, diarrhea, or infertility. Some patients with non- Hodgkin lymphoma may also receive drugs called biological therapy – treatments that improve the body’s defenses against the disease. For example, the drug rituximab, given by infusion, attaches itself to a molecule on the surface of cancerous B cells, inactivating the cancer cells. Side effects include fever, chills, itching or lightheadedness. Radiation therapy uses high- energy rays to kill lymphoma cells by damaging the genetic material they contain. Some patients receive targeted radiation from a large machine aimed at the neck, armpits or other parts of the body affected by lymphoma. This type of therapy takes place five days a week for several weeks. Others may receive radiation directed to larger areas of the body. The side effects of radiation therapy, including fatigue, can depend on the dose of radiation and the part of the body that is treated. Skin in the area being treated may become red, dry, and tender. Hair loss in the treated area also may occur. A bone marrow transplant or stem cell transplant gives a patient healthy stem cells – immature cells that grow into different parts of the blood – taken from the marrow, the soft, fatty tissue inside the bones, replacing bone marrow that is either not working properly or has been destroyed by chemotherapy or radiation. Stem cells may be taken from the patient before getting chemotherapy or radiation. They also may come from a relative or other donor, or from umbilical cord blood. Most patients get high doses of chemotherapy, radiation, or both, before the bone marrow transplant to kill any cancer cells that might remain and make room for new stem cells to grow. Doctors then deliver the stem cells through a tube injected into the bloodstream. They find their way into the bone marrow and begin reproducing to make healthy new blood cells. While receiving stem cells, patients may experience pain, chills, fever, hives, chest pain or other symptoms. Vaccine – Researchers at Johns Hopkins Kimmel Cancer Center and other medical centers across the country are researching and testing novel vaccines to help fight lymphomas. Lymphoma Survivorship. Lymphoma survivors may have lingering side effects such as bone or joint pain, numbness and tingling of the hands and feet (peripheral neuropathy), difficulty concentrating, fatigue, hot flashes, or night sweats. Remember that your body needs time to recover; effects like fatigue may last for a year or more. Premenopausal women may experience menopausal symptoms. Always discuss any health concerns and symptoms with your doctor. As you recover, take charge of your health by eating healthy, exercising and reducing stress. Avoid tobacco and limit alcohol intake. Keep up with screenings for other cancers, like mammographies and colonoscopies. Patients with non- Hodgkin and Hodgkin lymphomas are managed by the faculty of the Division of Hematologic Malignancies at the Sidney Kimmel Kimmel Comprehensive Cancer Center at The Johns Hopkins Hospital. More information on our Blood and Bone Marrow Cancers Program. The Lymphoma Research Foundation and The Leukemia and Lymphoma Society provide information and resources for patients and survivors.
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November 2017
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