Lymphoma Subtypes and Classification
- Mature B cell neoplasms
- B-cell chronic lymphocytic leukemia/small cell lymphoma
- B-cell prolymphocytic leukemia
- Lymphoplasmacytic lymphoma (such as Waldenström macroglobulinemia)
- Splenic marginal zone lymphoma
- Plasma cell myeloma (also known as multiple myeloma)
- Plasmacytoma
- Monoclonal immunoglobulin deposition diseases
- Heavy chain diseases
- Extranodal marginal zone B cell lymphoma, also called MALT lymphoma
- Follicular lymphoma
- Mantle cell lymphoma
Risk Factors and Symptoms of Lymphoma
- Epstein-Barr virus (EBV) infection
- Weakened immune system
- Exposure to certain chemicals and pesticides
- Family history of lymphoma
- Age (risk increases with age)
- Enlarged lymph nodes
- Fatigue
- Night sweats
- Unexplained weight loss
- Fever
Diagnosis and Staging of Lymphoma
- Biopsy to confirm diagnosis
- Staging tests to determine the extent of the disease
- Imaging tests (CT scan, PET scan)
- Bone marrow biopsy
- Blood tests (complete blood count, lymph node biopsy)
- Staging (Lugano classification, Ann Arbor staging system)
Treatment Options for Lymphoma
- Chemotherapy
- Radiation therapy
- Immunotherapy
- Targeted therapy
- Stem cell transplantation
Prognosis, Survival Rates, Palliative Care, and Supportive Measures
- Survival rates vary depending on the type and stage of lymphoma
- Hodgkin lymphoma has a high overall survival rate
- Non-Hodgkin lymphoma survival rates vary widely
- Burkitt lymphoma has a high cure rate with intensive treatment
- Mantle cell lymphoma has a lower survival rate compared to other types of lymphoma
- Palliative care focuses on improving quality of life and managing symptoms
- Pain management
- Emotional and psychological support
- End-of-life care
- Support for caregivers and family members
Lymphoma is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). The name typically refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlarged lymph nodes, fever, drenching sweats, unintended weight loss, itching, and constantly feeling tired. The enlarged lymph nodes are usually painless. The sweats are most common at night.
Lymphoma | |
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Follicular lymphoma replacing a lymph node | |
Specialty | Hematology and oncology |
Symptoms | Enlarged lymph nodes, fever, sweats, unintended weight loss, itching, feeling tired |
Risk factors | Epstein–Barr virus, autoimmune diseases, HIV/AIDS, tobacco smoking |
Diagnostic method | Lymph node biopsy |
Treatment | Chemotherapy, radiation therapy, proton therapy, targeted therapy, surgery |
Prognosis | Average five year survival 85% (USA) |
Frequency | 4.9 million (2015) |
Deaths | 204,700 (2015) |
Many subtypes of lymphomas are known. The two main categories of lymphomas are the non-Hodgkin lymphoma (NHL) (90% of cases) and Hodgkin lymphoma (HL) (10%). Lymphomas, leukemias and myelomas are a part of the broader group of tumors of the hematopoietic and lymphoid tissues.
Risk factors for Hodgkin lymphoma include infection with Epstein–Barr virus and a history of the disease in the family. Risk factors for common types of non-Hodgkin lymphomas include autoimmune diseases, HIV/AIDS, infection with human T-lymphotropic virus, immunosuppressant medications, and some pesticides. In 2014, the International Agency for Research on Cancer updated its classification of trichloroethylene to Group 1, indicating that sufficient evidence exists that it causes cancer of the kidney in humans as well as some evidence of cancer of the liver and non-Hodgkin's lymphoma. Eating large amounts of red meat and tobacco smoking may also increase the risk. Diagnosis, if enlarged lymph nodes are present, is usually by lymph node biopsy. Blood, urine, and bone marrow testing may also be useful in the diagnosis. Medical imaging may then be done to determine if and where the cancer has spread. Lymphoma most often spreads to the lungs, liver, and brain.
Treatment may involve one or more of the following: chemotherapy, radiation therapy, proton therapy, targeted therapy, and surgery. In some non-Hodgkin lymphomas, an increased amount of protein produced by the lymphoma cells causes the blood to become so thick that plasmapheresis is performed to remove the protein. Watchful waiting may be appropriate for certain types. The outcome depends on the subtype with some being curable and treatment prolonging survival in most. The five-year survival rate in the United States for all Hodgkin lymphoma subtypes is 85%, while that for non-Hodgkin lymphomas is 69%. Worldwide, lymphomas developed in 566,000 people in 2012 and caused 305,000 deaths. They make up 3–4% of all cancers, making them as a group the seventh-most common form. In children, they are the third-most common cancer. They occur more often in the developed world than the developing world.