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Lymphoma

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Lymphoma

A Cancer of the Lymphatic System

What is Lymphoma?

Lymphoma is a type of blood cancer that begins in the lymphatic system, which is part of the immune system. The lymphatic system includes the lymph nodes, spleen, bone marrow, thymus, and lymphatic vessels. Its role is to fight infections and filter harmful substances.

In lymphoma, white blood cells (lymphocytes) grow uncontrollably, forming tumours in lymph nodes or other parts of the body.

Types of Lymphoma

There are two main categories of lymphoma:

  1. Hodgkin Lymphoma (HL)
    • Characterized by the presence of Reed-Sternberg cells
    • Most common in young adults and teenagers
    • Has a high cure rate, even in advanced stages
  2. Non-Hodgkin Lymphoma (NHL)
    • More common than HL
    • Has many subtypes (over 60 types) like:
      • Diffuse Large B-Cell Lymphoma (DLBCL) – Most common
      • Follicular Lymphoma
      • Mantle Cell Lymphoma
      • Burkitt Lymphoma
    • Can be aggressive (fast-growing) or indolent (slow-growing)

Symptoms of Lymphoma

Symptoms may develop gradually or suddenly, depending on the type:

  • Swollen, painless lymph nodes in neck, underarm, or groin
  • Fever (especially at night)
  • Unexplained weight loss
  • Persistent fatigue or weakness
  • Night sweats (drenching)
  • Loss of appetite
  • Itching all over the body (pruritus)
  • Cough, shortness of breath, or chest pain (if lymph nodes are in the chest)
  • Abdominal swelling or pain (due to spleen/liver involvement)

B symptoms (fever, night sweats, weight loss) are important for staging and prognosis.

Where Can Lymphoma Occur?

  • Lymph nodes
  • Spleen
  • Bone marrow
  • Thymus
  • Tonsils
  • Intestines or stomach (MALT lymphoma)
  • Central nervous system (rare)

Causes & Risk Factors

  • Weakened immune system (HIV/AIDS, organ transplant patients)
  • Infections (e.g., Epstein-Barr virus, H. pylori, Hepatitis C)
  • Autoimmune diseases (e.g., rheumatoid arthritis, lupus)
  • Previous cancer treatments (chemotherapy or radiation)
  • Genetic predisposition
  • Age – HL is more common in young adults; NHL in older adults
  • Exposure to certain chemicals (pesticides, herbicides)

Diagnosis of Lymphoma

  1. Physical Examination
    • To check for swollen lymph nodes or spleen
  2. Blood Tests
    • CBC (Complete Blood Count)
    • LDH (Lactate dehydrogenase) – often elevated in aggressive lymphoma
  3. Lymph Node Biopsy
    • A tissue sample is examined under a microscope to confirm the type of lymphoma
  4. Bone Marrow Biopsy
    • To assess spread into bone marrow
  5. Imaging Tests
    • CT scan, MRI, or PET-CT scan – to determine the extent of disease
  6. Immunophenotyping / Flow Cytometry
    • Identifies the type of lymphocyte involved (B-cell, T-cell, etc.)

Staging of Lymphoma (Ann Arbor System)

  • Stage I: One lymph node region or single organ involved
  • Stage II: Two or more lymph node areas on the same side of the diaphragm
  • Stage III: Lymph nodes on both sides of the diaphragm
  • Stage IV: Spread to organs outside the lymphatic system (e.g., liver, bone marrow)

Each stage is also marked with:

  • A (no symptoms)
  • B (presence of fever, night sweats, weight loss)

Treatment Options at Onco-Life Cancer Centre

Our approach is tailored to lymphoma type, stage, aggressiveness, and patient profile.

  1. Chemotherapy
    • Backbone of treatment (e.g., ABVD, CHOP, R-CHOP protocols)
    • Given in cycles over weeks to months
  2. Immunotherapy
    • Rituximab (targets CD20 on B-cells)
    • Monoclonal antibodies boost immune attack on cancer cells
  3. Targeted Therapy
    • Used in relapsed or specific lymphoma subtypes
    • Examples: Ibrutinib, Venetoclax, Bortezomib
  4. Radiation Therapy
    • Used for early-stage or bulky disease
    • Onco-Life offers precision Tomotherapy to minimize side effects
  5. Bone Marrow / Stem Cell Transplant
    • For high-risk or relapsed lymphomas
  6. Supportive Care
    • Antibiotics for infections
    • Blood transfusions
    • Pain relief, nutrition, and psychological support

Prognosis and Follow-Up

  • Many lymphomas are curable, especially Hodgkin and some aggressive NHLs
  • Regular follow-ups include scans, blood tests, and clinical check-ups
  • Long-term survivors need monitoring for secondary cancers or late side effects

Lymphoma in India

  • Rising due to urbanization, pollution, lifestyle, and undiagnosed immunosuppression
  • Often confused with tuberculosis or infections
  • Many patients seek help late due to lack of awareness

Most Popular Questions

Lymphoma

1. Is lymphoma curable?

Yes. Many types, especially Hodgkin and aggressive NHL, are curable with proper treatment.

2. What is the difference between lymphoma and leukaemia?

Lymphoma affects lymph nodes and immune tissue; leukaemia affects bone marrow and blood.

3. Can lymphoma spread to the brain?

Yes, in certain types like Burkitt lymphoma or aggressive NHLs. Treatment may include brain prophylaxis.

4. Is lymphoma painful?

Swollen lymph nodes are usually painless, but large nodes can cause discomfort or pressure.

5. Is chemotherapy always needed?

Most cases need chemo. Some early-stage lymphomas may be treated with radiation alone.

6. Can children get lymphoma?

Yes. Certain types like Burkitt lymphoma and lymphoblastic lymphoma occur in children.

7. How is Hodgkin lymphoma different from Non-Hodgkin lymphoma?

Hodgkin has Reed-Sternberg cells and better prognosis. NHL includes many subtypes with variable behavior.

8. What is R-CHOP?

A common chemotherapy regimen for NHL: Rituximab + Cyclophosphamide + Doxorubicin + Vincristine + Prednisone

9. What is a PET-CT scan used for?

To check for spread and response to treatment. It’s crucial in lymphoma staging.

10. Can lymphoma relapse after treatment?

Yes. Relapse is possible and often treatable with stronger therapies or transplant.

11. Is lymphoma hereditary?

Mostly no. Some rare genetic links exist, but it’s usually not inherited.

12. Does diet affect lymphoma?

No specific foods cause it, but good nutrition helps recovery during treatment.

13. Can I exercise during treatment?

Light activity is encouraged if tolerated. Avoid strenuous tasks during chemotherapy.

14. Are blood transfusions necessary?

Sometimes, especially in patients with anemia or low platelets.

15. Is immunotherapy better than chemo?

They work together. Immunotherapy enhances immune attack, while chemo kills fast-growing cells.

16. How long is treatment?

Most treatments last 3–6 months. Indolent types may need long-term monitoring.

17. Can lymphoma cause fever?

Yes, especially night fevers — part of “B symptoms” indicating aggressive disease.

18. Is radiation therapy safe?

Yes, especially with advanced technologies like Tomotherapy that limit damage to nearby organs.

19. What’s the survival rate for Hodgkin lymphoma?

Over 85% for early-stage cases; even advanced stages are curable in many patients.

20. Is lymphoma contagious?

No. It cannot spread from one person to another.