Lymphomas (Hodgkin and Non-Hodgkin)

Lymphoma is a broad term for cancers that form in the body’s lymphatic system, part of the immune system. There are two types of lymphoma: Hodgkin’s and non-Hodgkin’s.

Hodgkin's lymphoma, formerly known as Hodgkin's disease, occurs when cells dividing in the lymphatic system grow at an accelerated, disorganized rate. Because the lymphatic system traverses the body, Hodgkin's lymphoma can originate anywhere and spread to organs like the liver, bone marrow, and spleen.

Non-Hodgkin's lymphoma, which is the more common of the two, occurs when white blood cells called lymphocytes grow abnormally and form tumors.

Both forms of lymphoma are relatively rare, but the prognosis for most patients is promising, especially with the support of doctors with the GW Cancer Center’s Malignant Hematology Program.

Risk Factors

Diagnosed most frequently in patients between ages 18 and 34, and after the age of 55
Occurs more often in men than in women
Family history
Having the Epstein-Barr virus
A weakened immune system due to HIV

Symptoms

Those who suffer from Hodgkin's lymphomas may experience a combination of the following symptoms:

Painless swelling in the neck, underarms or groin
Fever
Night sweats
Weight loss
Itchiness
Constant fatigue

Detection and Diagnosis

X-rays, CAT scans, magnetic resonance imaging (MRIs) and positron emission tomography (PET) scans are used by physicians to detect cancerous growth.

X-rays take pictures of the inside of the body with high-energy radiation. CAT scans take more detailed pictures of the inside of the body with an x-ray machine linked to a computer.

MRI's also take detailed pictures, but with a powerful magnet linked to a computer.

PET scans gives more information about how organs and tissues are working useing a radioactive substance called a tracer.

To make a diagnosis, a pathologist must perform a biopsy, or examine a piece of tissue removed by a surgeon from one of the patient's lymph nodes under a microscope.

Treatment Options

Radiation therapy kills cancer cells with intense x-rays aimed only at the cancerous growth. Radiation can be emitted from outside the patient's body or radioactive materials can be placed internally at the targeted area. Side effects from radiation therapy include loss of appetite, fatigue, nausea, vomiting and problems with digestion.

Chemotherapy involves taking drugs which kill cells that are growing rapidly, thus noncancerous cells can be killed as well. Side effects vary by type of drug but in general, hair loss, nausea, vomiting, diarrhea, loss of appetite, sores on the mouth and the lips and a lower resistance to infection are expected.

Bone marrow transplantation is reserved for cases when the Hodgkin's disease returns.

Non-Hodgkin's Lymphoma

Non-Hodgkin's lymphoma occurs when cells dividing in the lymphatic system grow at an accelerated, disorganized rate. Because lymphatic vessels branch throughout the body, non-Hodgkin's lymphoma can arise anywhere and spread to organs like the liver, bone marrow and spleen.

Risk Factors

Men are at a slightly greater risk than women
Advanced age
A weakened immune system due to HIV
Autoimmune diseases
Immunosuppressant drugs after organ transplants
Inherited immune deficiencies
Exposure to some chemicals like fertilizers, pesticides or solvents
A history of certain viruses may precede non-Hodgkin's lymphoma

Symptoms

Those who suffer from non-Hodgkins lymphomas may experience a combination of the following symptoms:

Painless swelling in the neck, underarms or groin
Fever
Night sweats
Weight loss
Itchiness
Red patches on the skin
Constant fatigue

Detection and Diagnosis

X-rays, CAT scans, magnetic resonance imaging (MRIs) and positron emission tomography (PET) scans are used by physicians to detect cancerous growth.

X-rays take pictures of the inside of the body with high-energy radiation. CAT scans take more detailed pictures of the inside of the body with an x-ray machine linked to a computer.

MRI's also take detailed pictures, but with a powerful magnet linked to a computer.

PET scans gives more information about how organs and tissues are working useing a radioactive substance called a tracer.

To make a diagnosis, a pathologist must perform a biopsy, or examine a piece of tissue removed by a surgeon from one of the patient's lymph nodes under a microscope.

Treatment Options

Radiation therapy kills cancer cells with intense x-rays aimed only at the cancerous growth. Side effects from radiation therapy commonly include hair loss and skin irritations in the targeted area and fatigue. Radiation to the abdomen may result in temporary upset stomach or diarrhea, while radiation to the chest may cause lung damage, swallowing and breathing problems. Brain radiation therapy can lead to cognitive difficulties.

Bone marrow transplantation (BMT) or hematologic stem cell transplantation (HSCT) is most commonly used for relapsed and recurrent lymphomas. This procedure supplies the patient with stem cells, which are cells that can develop into other types of cells, to replace those that have been damaged by other treatments. Stem cells can be transplanted from either person or patient. The cells have been removed and frozen. Risk of infection is high immediately following bone marrow transplantation.

In autologous BMT/HSCT, the patient serves as his own donor. Most often the stem cells are collected from the blood, where they have been 'tricked' to leave the bone marrow, where they usually reside. They are processed and frozen. After the patient receives high-dose chemotherapy, with or without radiation, they are given back their thawed stem cells as blood transfusion. These cells will replace the previously destroyed calls and allow the body to recover much faster.

In allogeneic, cells for a fully matched donor (usually a sibling), are given after high-dose chemo/radio therapy. This approach can be complicated by rejection called graft-versus-host disease. Transplants between identical twins (syngeneic) does not carry this risk.

Biological therapies make use of products of the body's own immune system. In a healthy person antibodies fight infection. Laboratory-made antibodies can fulfill the same function. Man-made monoclonal antibodies are designed to treat only lymphoma cells. Interferon, a protein usually generated by white blood cells, is known to shrink or stop the growth of lymphoma.

Program(s)

Lymphoma Program