What is non-Hodgkin’s lymphoma (NHL)
NHL is a cancer of the lymphatic system, which is part of the immune system of the body. It happens when lymphocytes, which are white blood cells, turn into tumours.Many kinds of cancer can spread to the lymph nodes, but lymphomas are the only ones that start in the lymph tissue.Hodgkin’s lymphoma is less common than NHL.
The Reed-Sternberg cell is an atypical type of cell that is present in Hodgkin’s lymphoma but not in NHL. This is the main difference between the two types of lymphoma. Only Hodgkin’s lymphoma has this type of cell. Also, there are very different ways to treat Hodgkin’s lymphoma and NHL.
Non-Hodgkin’s lymphoma types
NHL comes in many different types, which are based on how the cells look when you look at them with a microscope. The two main types of NHL are B-cell lymphoma and T-cell lymphoma.
According to the American Cancer Society (ACS), about 85 percent of NHL cases in the United States are B-cell lymphomas.Diffuse large B-cell lymphoma and follicular lymphoma are the most common types of B-cell lymphoma. About one in three cases of lymphoma are caused by large B-cells. Trusted Source, and about 1 out of every 5 cases is follicular lymphoma.Some types of B-cell lymphoma that are less common are
- Burkitt’s lymphoma, which is also known as small noncleaved cell lymphoma
- marginal zone B-cell lymphoma
- lymphoplasmacytic lymphoma
- primary mediastinal large B-cell lymphoma
- small lymphocytic lymphoma
The American Cancer Society (ACS) says that less than 15% of lymphomas in the United States are T-cell lymphomas. Less than 1% of lympomas in the US are caused by natural killer cells.Symptoms of non-lymphoma Hodgkin’s
Some of the signs of NHL are:B symptoms” are signs that help doctors figure out how bad NHL and Hodgkin’s lymphoma is, how likely it is to get worse, and how far along it is. These are the B signs:
night sweats that soak you
if you lose more than 10% of your body weight in 6 months,
If you have persistent symptoms that worry you, you should always talk to your doctor.
Non-lymphoma Hodgkin’s happens in these places:
Lymphoma affects the lymphatic system, which helps the body fight off diseases and infections. The lymphatic system also helps the body’s fluids move around.Lymphomas can begin anywhere there is lymph tissue. The skin can also be hurt by them.
Some important places where lymph tissue is found are
Adenoids and tonsils
Causes of Non-lymphoma Hodgkin’s
Researchers have found links between NHL and a number of risk factors, but they still don’t know what causes these cancers.
NHL is a type of blood cancer that starts in the lymphatic system and grows there. It starts out as B cells, T cells, or natural killer cells, which are all types of white blood cells.
B cells (B lymphocytes). By making proteins called antibodies, B cells help protect the body from germs and viruses.
T cells (T lymphocytes). T cells are a group of many different kinds of cells. Some T cells kill pathogens or other cells that don’t belong in the body. Some help other immune system cells do their jobs better.
Natural killer cells (NK cells). B cells and T cells are related to natural killer cells. They stop and slow the growth of some tumours and microbial infections.
NHL has been linked to changes in chromosomes, which are parts of your DNA. When chromosomal changes happen, like translocations, mutations, or deletions, the body starts to make lymphocytes that are different from normal ones. These atypical lymphocytes keep growing and dividing, which causes the lymph nodes to get bigger and cancerous tumours to form.
These chromosomal changes can be caused by DNA mutations passed down from a parent or by changes in genes that happen as you grow older. Genes can change when a person is exposed to radiation, certain chemicals that cause cancer, or an infection.
Gen changes seem to happen more as we get older, which could be why lymphomas are more common in older people. But changes in genes often happen for no clear reason.
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Find out about new research, nutrition, preventing cancer, chemo, and other things that can help you on your cancer care journey..Chances of getting Non-lymphoma Hodgkin’sMany people with NHL don’t seem to be at risk in any obvious way. NHL can also happen even if you have more than one risk factor.
Here are some things that might make you more likely to get NHL:
Older age. Most people are at least 60 when they are told they have it.Gender. NHL is more likely to happen to men than to women.About the family. If you have a parent, child, or sibling who has NHL, you are more likely to get it yourself.Having to carry more weight. A review of research from 2015 shows that being overweight or obese might make you more likely to get certain types of NHL.Getting new breasts. In rare cases, a type of anaplastic cell lymphoma can grow in the breast of a person who has breast implants.Being around some chemicals. There may be a link between weed killers and a higher risk of NHL. We need to do more research.
Radiation exposure. People who lived through atomic bombs or accidents in nuclear reactors are more likely to get NHL and a few other types of cancer.Things that make the immune system less strong. NHL has been linked to some autoimmune diseases, like rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s disease, and celiac disease. Some types of NHL, like diffuse large B-cell lymphoma, are also more likely to happen if you have HIV.
Infections that keep the immune system working hard. Hepatitis C, Chlamydophila psittaci, and Helicobacter pylori are all examples of these kinds of infections. They may make a person more likely to get lymphoma because they make the immune system work all the time.
Infections that mess with the DNA of lymphocytes. Infections with Epstein-Barr virus and Helicobacter pylori are two of the things that can cause lymphocytes to change into cancer cells.NHL is also more likely to happen to white people in the United States than to African American or Asian American people.Diagnosing non-lymphoma Hodgkin’s
NHL can be found through a number of tests.You can check the size and health of your lymph nodes with a physical exam. A physical exam can also find a liver or spleen that is too big.
When your body fights an infection, your lymph nodes will get bigger. Your doctor may do tests on your blood and urine to find out what kind of infection your body is fighting.
Imaging tests like the ones below can help your doctor find tumours and figure out how far along the cancer is:
PET scan stands for positron emission tomography.
During a biopsy, your doctor can take a small piece of a lymph node to test it. This is a sure way to find NHL. A bone marrow biopsy can tell your doctor if the disease has spread to other parts of your body.
Blood tests are also used to figure out how far along the lymphoma is.Treatment for non-lymphoma Hodgkin’sHow you treat NHL depends on how old you are, what kind of NHL you have, and how far along it is.Not every time needs to be treated right away. Your doctor may just watch a slow-growing NHL that isn’t causing any symptoms. Treatment can be put off until the illness gets worse.
There are several ways to treat NHL that is more dangerous.
Some of the medicines on this list were first made to treat other health problems. Even though the Food and Drug Administration (FDA) hasn’t approved all of them to treat NHL, your doctor may still give them to you. This is called “off-label” use of a drug.
OFF-LABEL DRUG USE
Off-label drug use is when a drug that has been approved by the FDA for one purpose is used for another purpose that hasn’t been approved.A doctor can still use the drug in this way, though. This is because the FDA only controls how drugs are tested and approved, not how doctors use them to treat their patients.So, your doctor can tell you to take a drug in any way they think will help you the most.
It can be taken by mouth or put into a vein. There are many different kinds of chemotherapy drugs, which are put into groups based on how they work:
es. Cyclophosphamide (Cytoxan), chlorambucil (Leukeran), bendamustine (Bendeka, Treanda), and ifosfamide are all alkylating agents (Ifex).Corticosteroids. Prednisone (Prednisone Intensol, Rayos) and dexamethasone are both corticosteroids (Hemady).
Platinum drugs. The heavy metal platinum is used to make drugs. There are three of them: cisplatin, carboplatin, and oxaliplatin (Eloxatin).Purine analogues. Fludarabine, pentostatin (Nipent), and cladribine are all examples of purine analogues (Mavenclad).
Antimetabolites. Cytarabine, gemcitabine (Infugem), methotrexate (Trexall), and pralatrexate are all antimetabolites (Folotyn).Anthracyclines. Anthracyclines are drugs that kill bacteria. Among them is doxorubicin (Doxil).Miscellaneous. Vincristine (Marqibo), mitoxantrone, etoposide, and bleomycin are some other chemotherapy drugs.Chemotherapy can be used by itself or in combination with other treatments. Find out more about the different kinds of drugs used in chemotherapy.
Treatment with x-rays
In radiation therapy, powerful beams of energy are used to kill cancer cells and remove tumours. Radiation can be used alone or in combination with other therapies.
Stem cell transplant
Your doctor can give you more chemotherapy if you have a stem cell transplant. This treatment kills cancer cells and stem cells at the same time. Then, your doctor uses a procedure called a transplant to put healthy cells back into the body.
Your doctor can either use your own cells or cells from someone else. If your cells are going to be used in the transplant, they must be taken from you ahead of time and frozen.
Immunotherapy is a type of treatment that kills or slows the growth of lymphoma cells by either boosting the immune system or using antibodies that are made in a lab to act like those made by the immune system. There are different ways to use antibodies to treat diseases.
Monoclonal antibodies are proteins that attack a specific target on cancer cells to kill them. Among them are:
The CD19 antigen is targeted by antibodies. B cells have a protein called CD19 on their surface. Tafasitamab is an example of one of these drugs (Monjuvi).
The CD20 antigen is targeted by antibodies. B cells have a protein called CD20 on their surface. These drugs include rituximab (Rituxan), obinutuzumab (Gazyva), ofatumumab (Arzerra), and ibritumomab tiuxetan (Zevalin).
The CD30 antigen is targeted by antibodies. T cells have a protein called CD30 on their surface. Some of these medicines are brentuximab and vedotin (Adcetris).
The CD52 antigen is targeted by antibodies. T cells have a protein called CD52 on their outsides. One of these medicines is alemtuzumab (Campath).Antibodies that go after the antigen CD79b. Polatuzumab vedotin is an example of one of these drugs (Polivy).Immunomodulating drugs, like thalidomide (Thalomid) and lenalidomide (Revlimid), change parts of the immune system to treat lymphoma.
Chimeric antigen receptor (CAR) T cell therapy is a treatment in which T cells are taken from a person’s blood and changed in the lab so that they have specific receptors on their surface. When these receptors find proteins on the surface of cancerous lymphoma cells, they can attach to them and kill the cells.
Targeted drug treatment
Standard chemotherapy drugs don’t always work, but sometimes targeted drug therapy does.A type of targeted drug therapy is the use of monoclonal antibodies. Some other kinds are:inhibitrs of the proteasome, such as bortezomib (Velcade)
Histone deacetylase inhibitors like belinostat (Beleodaq)Bruton’s tyrosine kinase inhibitors like ibrutinib (Imbruvica) and acalabrutinib are used to treat cancer (Calquence)inhibitors of phosphoinositide 3-kinase, like idelalisib (Zydelig) and duvelisib (Copiktra)enhancer of zeste homolog 2 inhibitors, like tazemetostat (Tazverik)
nuclear export, like the drug Selinexor (Xpovio)Non-lymphoma Hodgkin’s can be stopped.We don’t know of any way to stop NHL. You might be able to lower your risk of getting the disease if you don’t do things like get fat or get HIV:Using barrier methods every time you have a sexual encounter can make it less likely that you will get HIV.
If you don’t use drugs intravenously or use clean needles when you do, you’re less likely to get HIV or hepatitis C.The following things can help stop people from getting fat and may protect them from getting lymphoma:keeping a healthy weight taking care of your body