Non-Hodgkin's lymphoma is one of the most common types of cancer that affects hundreds of people around the world. To understand how to recognize a disease and treat it, you must first understand what it is.
Non-Hodgkin's lymphoma is a collective concept, it refers to a whole group of oncological diseases in which malignant cells affect lymphoid tissues. In other words, this category includes all types of existing lymphomas with the exception of Hodgkin's lymphoma. A distinctive characteristic of the latter is the presence of altered and multinucleated cells in the affected tissues.
Features of the disease
Non-Hodgcon's lymphomas include about 80 different diseases that differ in aggressiveness and localization.
Among patients, there is approximately the same number of men and women, although in some varieties of the disease there is still a dependence on gender. As for the age categories, older people have a slightly higher risk of developing oncology. Meanwhile, the disease is often diagnosed in children.
Since non-Hodgkin's lymphomas are not one, but many diseases united by one characteristic, several forms and varieties should be considered at once. Such features as the duration and intensity of the course of therapy, the prognosis of treatment and possible concomitant diseases will directly depend on the characteristics of the disease.
B-cell form
The most common type of classification can be considered the one adopted by the World He alth Organization. It is based precisely on the cellular composition of oncology. There are 2 broad categories: B-cell and T-cell lymphomas. Each of them should be mentioned in more detail.
What is B-cell non-Hodgkin's lymphoma? This is a malignant disease of the lymphoid tissue, in which B-lymphocytes are affected. Their main task is to produce antibodies, therefore, they are also involved in the immune humoral response. There are several types of lymphomas here:
- Nodal and splenic. These species are characterized by slow growth.
- Burkitt's lymphoma. According to medical statistics, it is men who are about 30 years old who are more likely to suffer from this form of the disease. Doctors are in no hurry to give favorable prognoses: with Burkitt's non-Hodgkin's lymphoma, the survival of patients for 5 years is only 50%.
- Follicular. In most cases, this oncological disease develops rather slowly, but it can turn into a diffuse form, which is characterized byrapid development.
- MALT lymphoma of the marginal zone. This form spreads to the stomach and increases slowly. With all this treatment, it is extremely difficult to treat.
- Primary mediastinal (or mediastinal). This disease most often affects women, the 5-year survival rate after treatment is 50%.
- Lymphocentric small cell. Development is slow, but the cure rate is quite low.
- Primary CNS lymphoma.
- Diffuse large non-Hodgkin's lymphoma. This variety refers to rapidly progressive oncological diseases.
Types of non-Hodgkin's T-cell lymphoma
T-cell lymphoma is a malignant disease in which there is an uncontrolled growth of T-lymphocytes. Their production occurs in the thymus and they support cellular (or barrier) immunity of the skin and mucous membranes.
- Lymphoblastic form. Most patients with this diagnosis are young men under 40 years of age. A favorable outcome of treatment is predicted only if the bone marrow is not involved in the process.
- Large cell non-Hodgkin's lymphoma anaplastic. Most often, this disease occurs in young people, but with timely diagnosis, it responds well to treatment.
- Extranodal NHL. This form of the disease affects T-killers, its aggressiveness can vary.
- Sezary syndrome (or skin). This form is often called fungal mycosis and is formed mainlyin older people (50-60 years old).
- Lymphoma with enteropathy. It is noticed that this type of cancer is typical for people with gluten intolerance. Characterized as extremely aggressive and difficult to treat.
- Angioimmunoblastic. This type is difficult to treat, and therefore doctors do not make favorable prognosis for life.
- Non-Hodgkin's lymphoma panniculitis-like. Such oncology develops in the subcutaneous fat. A characteristic feature of this form is low sensitivity to chemotherapy, which makes the treatment ineffective.
Species by aggressiveness
Another option for classifying Neodzhkin's lymphomas is the division according to the aggressiveness of the process. This is very convenient for doctors, as it allows them to optimally choose the course of treatment and tactics of observation.
- Aggressive NHL. This type includes oncological diseases with rapid development, active spread, and in some cases with resistance to chemotherapy. The prognosis of treatment here can be made based mainly on the stage of oncology at which non-Hodgkin's lymphoma was detected. Relapses of these forms of the disease occur quite often.
- Indolent. Unlike the previous form, indolent lymphoma grows slowly and metastasizes. Sometimes cancers of this form may not manifest themselves for years (that is, they do not cause pain and other symptoms of pathology in a person). In general, with timely treatment of non-Hodgkin's lymphoma, the prognosis here is quite good.
- Intermediate. Suchtypes of diseases begin slowly, but increase in pace over time, tending more towards aggressive forms.
Reason for development
Until now, doctors have not been able to accurately identify the factors that provoke the development of non-Hodgkin's lymphoma of any type. However, the following point should be taken into account here. According to its origin, the disease is divided into:
- primary - oncology primarily affects lymphoid tissues (an independent focus), and then metastasizes to other organs;
- secondary - in this case, this disease acts as metastases, so the presence of malignant cells in the body can be called the cause.
If we talk about the causes of primary lymphoma, then in medicine there are several factors:
- Infections in the body. The hepatitis C virus, HIV infection, or human herpes virus (type 8) can provoke the appearance of pathological cells. Epstein-Barr virus often causes Burkitt's lymphoma, or the follicular form of the disease. People exposed to the bacterium Helicobacter pylori (which causes stomach ulcers) have a markedly increased risk of developing MALT lymphoma.
- Some genetic diseases. Among them are: ataxia-telangiectasia syndrome, Chediak-Higashi syndrome, and Klinefelter's syndrome.
- Ionized radiation in any dose.
- Influence of benzenes, insecticides, herbicides and many other mutagens or chemical carcinogens.
- Diseases of an autoimmune nature. characteristican example would be rheumatoid arthritis or systemic lupus erythematosus.
- Long-term use of various immunosuppressants.
- Age-related changes in body tissues. With age, the risk of developing non-Hodgkin's lymphoma increases markedly. A doctor's recommendation to reduce this risk is regular medical check-ups. This will make it possible to identify the disease at an early stage and start treatment in a timely manner.
- Overweight.
It is worth noting: the presence of one or several factors from the above list does not at all mean the indispensable development of oncological diseases. They only increase the risk of its occurrence.
Stages of lymphomas
The entire period of the course of cancer is usually divided into 4 stages (stages), and lymphoma in this case is no exception.
1 stage. Non-Hodgkin's lymphoma at this stage is represented by the defeat of one lymph node or the appearance of one independent focus. No local manifestations yet.
2 stage. This stage includes a malignant neoplasm that has spread to two or more lymph nodes and also went beyond the lymph nodes, but is localized only on one side of the diaphragm. So, the tumor can spread either only in the abdominal cavity or only in the chest.
3 stage. The next stage of development is the presence of foci on both sides of the diaphragm.
4 stage. This stage of development of lymphoma is considered the last. At this time, the lesion extends to the bone marrow, skeleton and central nervous system. This stagenot in vain is considered the last and most difficult for the patient. One of the manifestations is constant severe pain, which can no longer be stopped with conventional analgesics.
Clinical picture
Symptoms of non-Hodgkin's lymphoma are very diverse and depend on the form of the disease and localization. A common sign of a malignant lesion of lymphoid tissues is an increase in lymph nodes (common or local) and pain in this area. This condition is accompanied by symptoms of damage to a particular organ or signs of general intoxication of the body.
T-cell forms often manifest themselves as follows:
- lymph nodes increase;
- there is an increase in the spleen and a violation of its work;
- lungs and skin are damaged.
There are also several symptoms that are characteristic of non-Hodgkin's lymphomas, but are absent in Hodgkin's lymphoma. Among them:
- damage to the lymph nodes of the mediastinum (the space of the chest cavity), there is swelling of the face and hyperemia (excessive blood flow to a certain part of the body);
- if malignant cells develop in the thymus, there is frequent shortness of breath and cough;
- an increase in the pelvic or retroperitoneal lymph nodes provokes kidney failure or hydronephrosis (gradual atrophy of the kidneys).
At the same time, it is impossible not to note the symptoms that accompany anyoncological disease. With non-Hodgkin's lymphoma, they begin to appear at stage 2 of the disease and gradually become brighter:
- a sharp decrease in performance, the appearance of weakness and fatigue;
- lack of appetite;
- weight loss;
- appearance of irritability, apathy;
- constant heavy sweating mostly at night;
- signs of anemia.
Diagnosis of lymphomas
An increase in lymph nodes indicates not only an oncological disease, but also the presence of an infection in the human body. If an infectious component is suspected, the patient is prescribed a drug designed to eliminate the focus. After some time, the inspection is repeated. If no improvement is observed, a number of laboratory tests and instrumental diagnostic procedures are prescribed. The principles and methods of treatment of non-Hodgkin's lymphoma the doctor will choose based on the results of the examination.
- Blood tests to determine the state of the body and search for pathology.
- Chest x-ray. As a result of this procedure, the condition of the lymph nodes of the chest is revealed.
- CT - computed tomography provides information about the status of all lymph nodes and the possible presence of metastases in other organs.
- MRI. Using magnetic resonance imaging, doctors determine the current state of the spinal cord and brain and the possible presence of malignant cells in them.
- PET. Under this term lies the diagnostic procedure of positron-emission tomography. During it, a special substance is injected into the patient's vein, which helps to identify all cancerous foci in soft tissues.
- Gallium scan. This method effectively complements PET, as it detects malignant cells in bone tissue.
- Ultrasound provides information about the state of internal organs.
- Biopsy. This diagnosis is the extraction of tumor cells and their further study in the laboratory. A biopsy can be performed in different ways, so there are incisional, excisional, puncture, spinal puncture and bone marrow aspiration.
Treatment
In each case, the course of treatment is prescribed taking into account the results of the diagnosis. Some forms of lymphomas do not require treatment at first (this includes types of tumors with slow development and no pronounced symptoms).
Chemotherapy. With non-Hodgkin's lymphoma, several courses of chemotherapy are prescribed. The therapeutic effect is achieved with the use of strong anticancer drugs, which are designed to block the growth and reproduction of pathological cells. The interval between courses is about 2 or 4 weeks. Dosage form: intravenous solutions or tablets.
Radiation therapy. The essence of the treatment comes down to the impact on the human body of ionized rays, which are detrimental to a cancerous tumor. Such treatment of non-Hodgkin's lymphoma in some cases is the main one, but most often it is combinedwith chemotherapy.
Surgery. In the case of lymphomas, surgery is used very rarely, due to its low efficiency. Its appointment makes sense only in case of limited spread of the tumor.
Immunotherapy. Treatment of non-Hodgkin's lymphoma is often carried out with drugs that contain interferon, monoclonal antibodies and chemotherapy drugs. The essence of such an impact is to supply the body with those substances that the human body produces on its own under normal conditions. Such drugs significantly reduce the size of the tumor, slow down its growth and dramatically increase the human immunity to fight the disease.
Bone marrow transplantation. This method of therapy is turned to when other types of treatment do not work. Before transplantation, the patient undergoes high-dose radiation or chemotherapy. Subsequent transplantation is required because high doses of radiation or drugs kill not only cancer cells, but also he althy tissue. It is for the restoration of the bone marrow that transplantation is prescribed.
Important! Self-medication with such a diagnosis is strictly prohibited! Lymphomas of any type and nature are not treated with folk remedies, this requires a professional approach and a set of measures to eliminate the tumor.
Forecast
As medical statistics and medical reviews show, non-Hodgkin's lymphoma is effectively treated at stages 1 and 2 of development. In this case, the survival of patients over the next 5 years is about 80%. This is a fairly high figure given the severity of the disease. In the case of treatment of patients with stage 3 oncology, the survival rate is lower, since the tumor has time to spread far beyond the focus, and it is much more difficult to cope with it. At stage 4, the survival rate is low - only 20%.
Doctors especially emphasize: even constant developments and researches in this area do not allow to treat oncological diseases with 100% efficiency. That is why a lot depends on the patient himself. Early detection of symptoms of the disease and contacting the clinic significantly increase the chance of a full recovery.
