Lymphoma

Lymphoma

Lymphoma refers to cancer in a patient’s white blood cells, or lymphocytes. It is the most common blood cancer in the United States, and includes those classified as non-Hodgkin lymphoma and Hodgkin lymphoma. In non-Hodgkin lymphoma, cancer may form from either B-cells or T-cells, and may be a slow-growing or fast-growing type. Nearly 71,000 new cases of non-Hodgkin lymphoma and nearly 9,200 new cases of Hodgkin lymphoma will be diagnosed in 2015, the National Cancer Institute estimates.

Hodgkin lymphoma is more common in men than women, and in whites and African Americans compared with other races. It is more common in early adulthood and later in life. Non-Hodgkin lymphoma is more common in men and whites, but its risk is not higher in childhood; it increases with advanced age. Survival for Hodgkin lymphoma has increased by nearly 70 percent since 1975, as modern treatment approaches have become more readily available. Survival for non-Hodgkin lymphoma is also on the rise, with monoclonal antibody treatments such as rituximab often proving effective at slowing or stopping the spread of certain subtypes of the disease.

Exposure to the Epstein-Barr virus or human immunodeficiency virus (HIV) increases the risk of developing lymphoma. Helicobacter pylori infection, often associated with stomach ulcers, also increases the risk for some non-Hodgkin lymphomas.

Symptoms of lymphoma may include extreme fatigue; headache; dizziness; itching; painless lumps in the neck, underarm, stomach, groin, or lymph nodes; pain below the ribs on the left side; fever; night sweats; chest, abdominal, or bone pain of unknown origin; vision changes; numbness or tingling in the hands and feet; bruising or bleeding; or unexplained weight loss.

Diagnosing non-Hodgkin lymphoma may begin with a physical exam, blood and urine tests, lymph node biopsy, lumbar puncture, or a bone marrow biopsy taken from the hip’s iliac crest to search for cancer cells. Computed tomography (CT) or positron emission tomography (PET) scans can help identify tumors in the body to better customize treatment.

Treatment for lymphoma includes chemotherapy, radiotherapy, targeted therapies, immunotherapy, stem cell transplants, steroid therapy, and combinations of these approaches.

Chemotherapy for lymphoma may be given on a specific schedule orally or through the bloodstream. Drugs may shrink tumors or prevent them from growing and causing side effects, such as abdominal pain. Side effects during treatment may include fatigue, nausea, vomiting, risk of infection, hair loss, loss of appetite, and diarrhea.

Immunotherapy boosts the body’s natural defenses to fight cancer. Targeted therapy identifies specific genes, proteins, or tissue environments that promote cancer growth and survival, and blocks those targets to inhibit the growth and spread of cancer cells.

Stem cell transplants may be used following strong chemotherapy and/or radiation protocols that damage stem cells in the bone marrow. The cells are harvested prior to chemoradiation, then returned intravenously after treatment so the body can begin to make healthy blood cells again.

The Leukemia and Lymphoma Society offers much more detailed disease information and support for patients and caregivers.