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Non Hodgkins Lymphoma

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Overview of Non Hodgkins Lymphoma

Non-Hodgkin lymphoma (NHL) is a type of cancer that originates in white blood cells. White blood cells are responsible for dealing with all the infections and foreign invasions in the body.

This disease first develops in the lymphatic system. The uncontrolled growth of white blood cells can lead to tumour formation in the whole body. This causes the lymphocytes to lose their abilities and the body is unable to deal with foreign infections.

Occurrence and Prevalence of Non-Hodgkin’s Lymphoma

NHL is a disease that majorly affects man. Every 1 in 41 males has a chance of getting this disease. 1 out of 52  females has a chance of acquiring this disease. This cancerous disease can affect any age group. It is also one of the most common types of cancer in teens, adults, and children.

Signs and Symptoms of Non Hodgkins Lymphoma

One of the most common symptoms of non-Hodgkin’s lymphoma is a painless swelling in either neck or armpit. Some other symptoms are as follows:

  • Sweating at nights 
  • Sudden weight loss
  • High body temperatures or fever 
  • Breathlessness
  • Itching sensation all over the body 
  • Coughing 
  • Swollen lymph nodes

Types of Non Hodgkins Lymphoma

Non-hodgkin’s lymphoma can be divided into more than 30 types depending upon the cancerous mutations of the white blood cells.

This disease is further subclassified on the basis of tumour growth whether it is fast-growing or slow-growing. 

Fast Growing Lymphoma

The subtype of non-hodgkin’s lymphoma in which the mutated cell growth is fast-paced.

  • Diffuse large B-cells lymphoma
  • Anaplastic large-cell lymphoma 
  • Burkitt lymphoma
  • Lymphoblastic lymphoma 
  • Mantle cell lymphoma 
  • Peripheral T-cell lymphoma

Slow-growing Lymphoma

In this subtype of this blood disease, cancer grows and spreads slowly.

  • Follicular lymphoma
  • Cutaneous T-cell lymphoma
  • Lymphoplasmacytic lymphoma
  • Marginal zone B-cell lymphoma
  • MALT lymphoma
  • Small-cell lymphocytic lymphoma

Burkitt Lymphoma

It is one of the fastest-growing forms of lymphatic cancer. In addition to being one of the most aggressive forms of lymphoma, it is one of the rare forms of cancer. This disease mainly affects the B-lymphocytes. B-lymphocytes are specialized cells that act as the first line of defense with the production of antibodies.

Lymphoplasmacytic Lymphoma

Lymphoplasmacytic lymphoma is a slow-growing non-Hodgkin’s lymphoma. This cancerous mutation originates from B-lymphocytes and then becomes out of control.

Causes of Non Hodgkins Lymphoma

The exact reason why people suffer from non-Hodgkin’s lymphoma disease is still unknown. But in most cases, this disease is caused due to white blood cells mutation. DNA is responsible for giving genetic and metabolic orders to the cells. If a mutation occurs the cells are not able to function normally. If the mutation happens in the lymphatic system it leads to the abnormal growth of white blood cells.

The mutated cells then began to multiply in the lymph nodes such as the neck, armpit, or groin.

With the passage of time, these lymphocytes can travel to other body parts as well. They might affect:

  • Bone marrow
  • Spleen
  • Liver
  • Lungs
  • Skin
  • Stomach
  • Brain

Most of the time non-Hodgkin’s lymphoma does not develop in a lymph node. Rather they initiate in an organ.

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Risk Factors of Non Hodgkins Lymphoma

Most of the time people that are diagnosed with this disease have no obvious risk factor. In other cases, a person might not develop this disease even when they have the given below risk factors.

Common risk factors for non-Hodgkin’s lymphoma are:

  • Medications

Those people who have undergone an organ transplant ought to take special medicines after such treatments. These medications may put a person at an increased risk of this disease.

  • Viral and Bacterial Infections

Various viral and bacterial infections can make a person more vulnerable to non-Hodgkin’s lymphoma. HIV is a classic example of viral infection. On the other hand, bacterial infections are also equally responsible for the onset of this disease.

  • Chemical Contamination

Pesticides and other chemicals which are mainly used to kill insects and weeds can be the cause of this cancerous disease. But the research on this prospect is currently limited.

  • Age

Older age may be another risk factor for non-Hodgkin’s lymphoma. Although this disease can occur at any age. People who are above 60 years of age are more likely to develop this disease.

  • Celiac Disease

People who are suffering from celiac disease have a large risk of developing this disease.

  • Family History

This is not an infectious disease. But people who have had a family history of lymphatic cancer are highly prone to such mutations.

Non-Hodgkin Lymphoma Complications

People who have recovered from this disease may suffer from the long-term effects. Major complications of this disease are as follows:

  • Weak Immune System

One of the most common complications of non-Hodgkin's lymphoma is a weak immune system. Mostly the immune system recovers within months and years of the treatment. In case of an improperly working immune system, the person is more susceptible to foreign invasions. Some of the common symptoms of infections are:

  • Fever
  • Headache 
  • Body sore 
  • Diarrhea 
  • Fatigue 
  • Rashes

  • Risk of Infertility

The common treatments for non-Hodgkin's lymphoma are chemotherapy and radiotherapy. Most of the time it is temporary but it can also be permanent.

  • Cancers

If a person has non-Hodgkin’s lymphoma then the chances of the person acquiring secondary cancers are also highly significant.

Furthermore, the treatment of cancer also increases the chance of getting another cancer. Chemotherapy and radiotherapy release radiation that affect the cells. This radiation exposure can then lead to the onset of mutation.

  • Cardiac Issues

A poor lymphatic system is not able to cope with bacterial intrusion and is at great risk of infections. That is why people who have had this disease are prone to develop cancerous mutations in their lymph nodes.

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Prevention

It is a disease that majorly occurs due to genetic mutations. Thus, there is no exact way to prevent it. Because there is no definite cause for a person to acquire this disease hence there is no exact way to prevent it. Still, there are some measures that a person can take to lower the overall risk.

  • Avoid Risk Factors for HIV

 If a person is suffering from an HIV infection then he or she is at a greater risk for developing non-Hodgkin lymphoma. So a person should avoid contracting an HIV infection. 

Being overweight is the main cause of a number of chronic diseases. Obesity can cause higher chances of getting NHL. Thus, make sure to maintain a healthy lifestyle to reduce the risk of this disease.

  • Avoid Radiation Exposure

Radiations are highly toxic for cells. These rays can disrupt the cellular ability of cells and can change their genetic structure. This toxic exposure can lead to the onset of the NHL. Therefore, make sure to avoid radiation exposures.

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Diagnosis

Some of the most used means for the diagnosis of this disease are:

  • Blood Tests

Non-Hodgkin’s lymphoma is a blood disease. That is why blood tests are mostly taken to understand the disease spread and to diagnose it. Given below are some blood tests which are recommended by the doctors:

  1. Complete Blood Count
  2. Blood Chemistry Test 
  3. Serum lactate dehydrogenase test 
  4. HBV, HCV, or HIV test

  • Lymph Node Biopsy

In this method, a tissue sample is taken from a swollen or infected lymph node. Physical examination is used to understand the condition of lymph nodes. The tissue sample is further analyzed to understand the presence of proteins in the cancerous cells.

It is a method in which the affected lymph node is usually removed during surgery. The removed lymph node is then unable to spread the disease. The lymph node is further used to study the cancerous mutation.

  • Needle Biopsy

In case the swollen lymph node is close to the blood vessels which are vital for the transfer of blood in the body, then this procedure is used. Needle biopsy is a method in which the tissue sample is obtained using a needle.

A needle biopsy can be classified as follows:

  • Fine Needle Aspiration

A small needle is used to withdraw the sample from an infected lymph node.

  • Core Needle Biopsy

A large needle is used to draw a large sample of the cancerous lymph node.

  • Imaging Testing

These types of affected lymph nodes are also detected with techniques that use visual imaging such as:

Treatment of Non Hodgkins Lymphoma | When to Consult a Doctor

Chemotherapy and Radiotherapy are one of the most common treatment methods. In certain cases, the person may not need treatment. If the cancer is small then only a biopsy is needed. The best possible treatment also depends upon the age and health of the person. The treatment for cancer can put a person at risk and that is why it is important to get a consultation from a doctor first. Some of the most used treatment methods are:

  • Chemotherapy

Chemotherapy is one of the most popular treatment methods for non-Hodgkin’s lymphoma. Medicines are given to the patients to kill the mutated cells. Chemotherapy can be provided to a patient alone or combined with radiotherapy.

Most of the time chemotherapy is given to a patient when cancer has spread to a wide range. It also has various complications. Complete hair loss is one such complication. Other complications of chemotherapy are nausea, loss of appetite, stomach disorders, easy bruising, and anemia.

  • High Dose Chemotherapy

In case the person is not getting better with the initial treatment of chemotherapy then the doctor may double the dose of medicines. This is known as high-dose chemotherapy. This is an extreme treatment that can highly affect the bone marrow.

  • Radiotherapy

This treatment is mostly given to patients at an earlier stage of the disease. Patients do not have to stay in the hospital for the procedure. It is a painless process but does have certain side effects. Some of the most common side effects are:

  1. Red patches on the skin
  2. Fatigue
  3. Vomiting
  4. Digestive issues such as loss of appetite

  • Medications

Medications are commonly given in a combined treatment with chemotherapy.  Chemotherapy when given with these medications is more effective. The main difference between these medications and chemotherapy is that these drugs help to stabilize cancerous patients. Some FDA approved medications are:

  • Copiktra (Duvelisib)
  • Crizotinib
  • Cyclophosphamide
  • Denileukin Diftitox

But there are some complications that are associated with these medicines such as:

  • A sudden increase in appetite 
  • Sleep issues at night 
  • Temperament issues

Note:  (Consult a Hematologist before taking any medications)

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