Lymphoma

Lymphomas, or cancers of the immune system, are a common form of cancer. The disease involves the lymphatic system, a system of glands (lymph nodes) and vessels that runs throughout the body manufacturing and circulating lymph, a pale fluid through which white blood cells and other components of the immune system travel.

There are two main divisions of lymphoma, Hodgkin's disease and non-Hodgkin's lymphoma (NHL), distinguished by the different types of white blood cells that they affect. Both have similar symptoms but affect different sections of the population and have different outcomes.

Hodgkin's disease is primarily a disease of young and middle-aged adults and is largely curable with treatment. Around 85 per cent of all lymphomas are of the NHL type. In NHL, cancerous or malignant lymphocytes multiply uncontrollably impairing normal cell function and the body's ability to fight infection. While a variety of different subtypes of NHL exist, most originate within the B lymphocytes (B cells), the antibody-forming cells of the body. 

Causes and Risk Factors

The annual incidence is rising rapidly, at a rate of between three and ten per cent every year in the Western World. Most new patients will be between 30 and 70 years old. As with most cancers, the precise cause of NHL is still a matter for debate.

Diagnosis and Screening

NHL consists of a variety of different disease subtypes depending on the precise nature of the lymphocyte population involved. Thus, no two patients will show exactly the same symptoms or disease course.

Initial clinical symptoms may include swelling of the lymph nodes, fever, anaemia, weight loss, night sweats and fatigue. A diagnosis of NHL is usually confirmed by a biopsy (or surgical removal) of a small piece of affected lymph node for microscopic examination. This will identify the grade, stage and lymphoma subtype. Other useful diagnostic procedures include clinical examination, X-ray and CT (computerised tomography) scan.

Management

Treatment will depend on the subtype, grade and stage of the patient's disease. Standard treatments for NHL currently include chemotherapy, radiotherapy or / and monoclonal antibody therapy. Autologous bone marrow transplantation using bone marrow taken from the patients themselves prior to treatment can also be effective in some patients