¿What promotes the development of lymphoma?
Lymphoma, also known as lymphatic cancer, is characterized by damage to lymphocytes, which are cells in the family of leukocytes.
Leukocytes are the defending cells of the broad immune system of the body and manifest themselves in diseases and infections.
In the development of lymphoma, B and T lymphocytes begin to proliferate abnormally due to growth gene failures.
This type of cell is found in the lymph nodes, although they are also found in the spleen, thymus, bone marrow, and other organs in smaller quantities.
Types of documented lymphomas
The repertoire of is broad, and each one grows at a variable rate and with a varied response to treatment.
Among those discovered, two remain in the top positions for their greater prevalence.
The most important ones: Hodgkin’s lymphoma and non-Hodgkin’s.
In Hodgkin’s lymphoma, B lymphocytes are more affected, and as a microscopic characteristic, Reed-Sternberg cells are observed in biopsies.
With more cases in men, this disease is more commonly seen between ages 15 to 34 and after 60, although there are also cases in children.
It can also be referred to as four subtypes, such as nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted.
There is an even rarer subtype derived from Hodgkin’s lymphoma, nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), with different behavior than the classic one.
On the other hand, non-Hodgkin’s lymphoma is any of them that is not Hodgkin’s, identified when Reed-Sternberg cells are not found.
It is the most common presentation among lymphomas and can occur at any age, although the probability increases with age.
There are more than 60 types of non-Hodgkin’s lymphoma, organized according to the rate of development and the type of affected lymphocyte.
To understand a little more, from slowest to fastest growth rate are low-grade or high-grade lymphomas.
Speaking of the most referred lymphocyte type, B type lymphomas account for the majority of cases. Both B and T lymphomas can be low or high grade.
Some types of high-grade B-cell and T-cell non-Hodgkin lymphomas include:
- Intravascular, mediastinal, and cutaneous large B-cell.
- Mantle cell.
- Burkitt.
- Anaplastic large cell lymphoma of T-cells
- Hepatosplenic T-cell.
- Sezary syndrome
- Angioimmunoblastic T-cell.
On the other hand, low-grade B-cell and T-cell non-Hodgkin lymphomas include:
- Follicular lymphoma of low-grade B-cells
- Waldenström macroglobulinemia
- Small lymphocytic.
- Subcutaneous T-cell lymphoma similar to panniculitis
- Mycosis fungoides
Lymphoma in early ages
During childhood, adolescence, and early adulthood, these are one of the most diagnosed cancers. It is the third most common cancer in childhood and takes first place from adolescence onwards.
Additionally, those in younger ages tend to be different from those seen in older ages and possibly with a more varied degree of involvement.
It should be noted that the symptoms and diagnostic methods do not vary too much between ages.
The good news is that in early ages is easier to overcome, which optimizes treatment and recovery.
The Risk Factors
Sometimes the development of any lymphoma is considered idiopathic, meaning unknown cause.
Despite this, there are reasons associated with its development, among the most common are the following:
As mentioned, age and male sex.
An immune system suppressed by infections or associated treatments.
Having contracted HIV/AIDS, Epstein-Barr virus or hepatitis C.
Having had an organ transplant.
Taking immunosuppressive medications such as those used in rheumatology.
Directly suffering from rheumatoid arthritis, systemic lupus erythematosus or Sjögren’s syndrome.
Having previously suffered from Hodgkin or non-Hodgkin lymphoma.
Having previously suffered from leukemia or T-cell lymphoma.
The clinical presentation of lymphomas, knowing how to identify them
The signs and symptoms caused by this cancer are not at all striking, as most of them usually occur in infections.
For a normal person, it is extremely difficult to relate a simple cough, fever, or fatigue to a cancerous process, these symptoms are typical of a lymphoma.
The clinical presentation when suffering from lymphoma includes:
Presence of painless lymphadenopathy (swollen glands) with random distribution, almost always in the neck, armpits or groin.
Symptoms characteristic of a flu, cough, fever and difficulty breathing.
Unexplained weight loss.
Night sweats.
Generalized itching.
Fatigue.
It is for this reason that for the doctor, it can also be tedious to come up with a diagnosis, however, attending in time reduces the severity of the cancer.
The diagnostic repertoire of lymphomas
The medical history accompanied by updated diagnostic tools allows for effective screening to find the disease.
Knowing the onset of symptoms, limitations in activities, noticeable changes in appetite and body weight, as well as pathological antecedents contribute to reducing the causes of the patient’s illness.
While histological, imaging, and biochemical diagnoses help in ruling out and confirming the current condition.
Lymph node biopsy is the most common technique, consisting of partially or completely removing the lymph node for microscopic examination.
It can be done through surgical biopsy or fine-needle biopsy; another method is bone marrow aspiration.
The most commonly used imaging methods are:
Ultrasound: observing inflamed lymph nodes closest to the skin.
Chest x-ray: observing the lymphatic composition of the chest and the condition of the heart and lungs; observing the placement of the catheter in chemotherapy.
Computed tomography and positron emission tomography: diagnosis and staging, choice of therapy, post-therapy results, and relapses.
Magnetic resonance imaging: its use is useful for checking for the appearance of any lymphoma in the central nervous system, head, and neck.
These imaging reviews allow for cancer staging, ranging from stage I (early) to stage 3 or 4 (more advanced).
Finally, molecular and blood analysis tests allow for verification of cell alterations and biochemical processes in the body.
Established treatments
The treatment is based on chemotherapy, radiation therapy, or immunotherapy, which are also used to fight other cancers.
In addition to these, stem cell transplants, T-cell therapies with chimeric antigen receptors (T-CAR), and even bone marrow transplants can also be established.
These transplants aim to replace the lymphocytic function that has been lost during the period of illness.
A more recent therapy involves oral medications known as kinase inhibitors, which act by inhibiting the replication of cancer cells.
However, the latter depends on the patient’s responsibility for taking the medication without mistakes or delays.
Although the therapeutic repertoire is extensive, most can cause complications when dealing with this disease.
Complications from the treatment of Hodgkin and non-Hodgkin lymphoma
In immunocompromised patients suffering from cancer of the lymphatic system and undergoing treatment, there is a risk of overly complicated infections.
Likewise, the application of live attenuated vaccines should be suspended for several months after completing the treatment.
The MMR (measles, mumps, and rubella), varicella-zoster, and BCG (tuberculosis) vaccines are some of the live attenuated vaccines.
Radiation and chemotherapy treatments cause infertility, hair loss, joint stiffness, muscle discomfort, and vomiting, among the most frequent.
Other less frequent problems include radiation pneumonitis followed by fibrosis, incontinence, and difficulty urinating.
The emergence of a new cancer happens very rarely and is the worst complication.
In principle, they are associated with radiation and chemotherapy, and it is that by destroying the malignant cells, they also damage the healthy ones.
Life after lymphoma
Any post-treatment complications will be reviewed by your doctor in order to remedy any alterations as much as possible.
Medical follow-up over the next few months is vital for the complete resolution of the problem, to observe any sequelae or, if necessary, to identify the possible reappearance of lymphoma.
Survival depends on various factors including age, sex, type of lymphoma, and type of treatment used.
Comorbidities, previous cancer spread, and the reappearance of the same are associated with expected lifespan.
In order to have the best possible quality of life, you will need to maintain a healthy diet, engage in physical activity frequently, and reduce stress levels.
This, along with the support of loved ones, can achieve beneficial results after overcoming lymphatic cancer.
