Both Hodgkin and non-Hodgkin are lymphomas: a type of cancer that starts in a type of white blood cell called lymphocyte. Lymphocytes are part of the immune system, which protects you from germs.
The difference between Hodgkin’s lymphoma and non-Hodgkin’s lymphoma is the specific type of lymphocytes involved in each. The pathologist can tell the difference between a Hodgkin’s lymphoma and a non-Hodgkin lymphoma by examining the cancer cells under a microscope.
Additional tests are used to determine the specific type of lymphoma.
Non-Hodgkin’s limphoma can cause many different symptoms and signs depending on the type of lymphoma and its location in the body. Sometimes, it may not cause any symptoms until it grows long enough.
Some common symptoms and signs are: Inflammation of the lymph nodes, fever, sweating and chills, weight loss, extreme exhaustion, swelling of the abdomen, feeling full after eating only a small amount of food, pain or pressure in the chest, cough or shortness of breath
Swollen lymph nodes.
Although swollen lymph nodes are a common symptom of lymphoma, they are most often caused by infections. The lymph nodes that grow as a reaction to an infection are called reactive nodules or hyperplastic nodules and are often painful to the touch.
Lymphoma ranks seventh in incidence by type of cancer in both men and women, remaining stable in recent years. In Spain, some 5,400 new cases of non-Hodgkin Lymphoma are diagnosed each year. Regarding mortality, it occupies the ninth position of cause of death by tumor in both sexes, representing 3% of the total deaths due to cancer. Mortality due to this tumor has been decreasing since the end of the nineties, at a rate of 3% less than annual mortality, reflecting a clear improvement in the effectiveness of treatments.
Non-Hodgkin’s lymphoma grows and spreads at different rates; It can be slow-growing or fast-growing. The treatments for slow-growing lymphoma and fast-growing lymphoma are different.
There are many different types of non-Hodgkin lymphoma, so determining the class of a lymphoma can cause a lot of confusion (even for doctors). The most common types of lymphomas are frequently classified based on whether they originate from B lymphocytes or T lymphocytes. B-cell lymphomas account for the majority (about 85%) of non-Hodgkin lymphomas, while T-cell lymphomas they represent less than 15%. There are many types of T-cell lymphoma, although all are relatively uncommon.
In many medical centers around the world there has been research on the causes, prevention and treatment of non-Hodgkin’s lymphoma.
Genetics.
Advances in understanding DNA changes in lymphoma cells have resulted in better and more sensitive tests to detect the disease. Some of these tests are already being used, and others are in development. When all this is well understood, drugs that block these processes can be developed.
Treatment.
Most research on non-Hodgkin’s lymphoma focuses on finding new and better ways to treat this disease.
Chemotherapy.
Many new chemotherapy drugs are being studied in clinical trials and new ways of combining drugs using different doses or different sequences of drug administration.
Stem cell transplants.
Researchers are continually improving stem cell transplant methods, including new ways to collect stem cells before transplantation.
Targeted therapies.
As more is known about lymphoma cells, it has been possible to develop more recent drugs that attack specific parts of these cells. These targeted therapy drugs are different from those used in conventional chemotherapy, which attack all rapidly growing cells. Targeted therapy drugs can work in some cases where chemotherapy is not effective, and often have different side effects.
Immunotherapy.
For some time, doctors know that people’s immune systems can help fight their cancers. Currently, scientists are trying to create new ways to promote this immune reaction. Some types of immunotherapy are already used to treat lymphoma, such as monoclonal antibodies or checkpoint inhibitors.
T cell therapy with chimeric antigen receptors (CAR), a technique that has shown encouraging results in preliminary clinical studies conducted against some difficult to treat lymphomas.
Vaccines against lymphomas: contrary to conventional vaccines, these vaccines are designed to help treat, not prevent, lymphomas. The goal is to create an immune reaction against lymphoma cells in patients whose disease is in its early stages or in patients whose disease is in remission. So far, lymphoma vaccines are only available in clinical studies.
Antibiotics.
Some types of lymphoma are strongly linked to infections. Researchers are finding that, in some cases, treating the infection actually helps treat the lymphoma. For example, MALT gastric lymphoma, which is related to infection by the bacterium Helicobacter pylori, can often be treated with antibiotics. More studies may be needed before antibiotics are part of conventional treatment for this type of lymphoma.
• The overall relative rate of 5-year survival for people with non-Hodgkin’s lymphoma is 70%, and the relative 10-year survival rate is 60%. But it is important to keep in mind that survival rates can vary widely in different types and stages of lymphoma.
• The international prognostic index of lymphoma depends on five factors: The age of the patient, the lymphoma stage, whether or not the lymphoma is in organs outside the lymphatic system, the general condition of the person and the lactate dehydrogenase (LDH) level in the blood, which increases with the amount of lymphoma in the body.
Sources: Mayoclinic / Sociedad española de Oncología Médica / National Cancer Institute /American Cancer Society
March 31, 2020
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