Lymphoma is a cancer that affects lymphocytes, which are cells that make up part of the body’s immune system (they help us fight infections). Lymphocytes are found in lymphatic tissue (mainly in the lymph nodes, spleen or bone marrow). There are two main types of lymphocytes: B lymphocytes and T lymphocytes.
In the case of lymphomas, a lymphoid cell reproduces uncontrollably. Because lymphoid tissue is found throughout the body, lymphomas can occur anywhere in the body and, from there, spread to other organs and tissues. Most cases start with an infiltration of a lymph node (nodal forms) but some specific subtypes may be restricted to the skin, brain, spleen… (extranodal forms).
The cause of lymphomas is unknown, although they are more frequent in patients with immune system diseases (AIDS, immunodeficiencies, organ transplant recipients, autoimmune disorders), infections (Helicobacter, Epstein Barr virus) and patients treated with chemotherapy or radiotherapy.
This includes more than 20 different types. From a practical point of view, NHL can be divided into two main groups based on their speed of growth:
Aggressive lymphomas (also know as high-grade lymphomas), which tend to grow and spread rapidly and cause severe symptoms. The most common ones are: diffuse large B-cell lymphoma (1/3 of all lymphomas), mantle cell lymphoma, peripheral T-cell lymphoma, Burkitt lymphoma, and lymphoblastic lymphoma.
Indolent lymphomas, also called low-grade lymphomas, behave less aggressively, with lymphadenopathies that can evolve for years while preserving their general condition. The most common of these are: follicular lymphoma, small lymphocyte lymphoma (similar to CLL, chronic lymphocytic leukemia), lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia, marginal zone lymphoma (including MALT lymphomas) and cutaneous lymphomas.
The symptoms of lymphomas are highly variable and depend on the specific type of lymphoma. In general, the most common symptom is the presence of a lymph node lymphadenopathy (enlarged lymph node)—which is usually not painful—in the neck, armpit or groin. Some patients may have an unexplained fever, night sweats (to the point of soaking their clothes), weight loss greater than 10% in the last six months, tiredness, itchy skin and reddish skin patches.
To make an accurate diagnosis, a biopsy of one of the enlarged lymph nodes should be taken and a disease extension study (tests to find out how many lymph node territories are affected) should be performed. Blood tests, one or more imaging tests (X-rays, ultrasound, CT, PET) and a bone marrow biopsy (biopsy of the hip bone) should be performed to assess the state of the bone marrow.
The treatment of lymphomas varies depending on the extent of the disease, but it is always based on the administration of different chemotherapy regimens and, on occasion, radiotherapy is associated with the affected areas. In patients considered high risk (with a very high risk of disease relapse) and especially after a relapse, autologous haematopoietic stem cell transplantation is prescribed.
The haematology unit offers comprehensive care for patients with haematological malignancies
The Service's team of professionals accompanies cancer patients throughout the whole disease process.
A clinical trial is a research study carried out on people with the aim of learning more about how the body reacts to certain treatments. These trials generally seek to find drugs that are more effective than the current best therapeutic option for patients, or that have similar efficacy but a better toxicity profile.
Bearing in mind that almost all currently available treatments are the result of clinical research, the importance of clinical trials is obvious.
The IVO has a clinical trials unit for all types of tumours and participates in phase 1-3 studies as well as other types of studies.
Whether you receive the news of an initial diagnosis of cancer or a relapse, coping with cancer can be emotionally overwhelming. Each person has their own way of coping with a lymphoma diagnosis, but there are some recommendations that can help you through this process: