Different Kinds of Non-Hodgkin Lymphoma
Various kinds of Non-Hodgkin Lymphoma have been found in humans. These include Hepatosplenic gamma/delta T-cell lymphoma, Burkitt lymphoma, and Primary effusion lymphoma. There are various treatment options available for these kinds of lymphomas.
Primary effusion lymphoma
Usually affecting HIV-positive patients, a primary effusion lymphoma is a rare form of high-grade non-Hodgkin’s lymphoma. The disease resembles diffuse large B-cell lymphoma (DLBCL) but is characterized by atypical B-cells with a null lymphocyte immunophenotype. It usually affects the pleural space or body cavities, especially the pericardium or peritoneum.
Primary effusion lymphoma is usually accompanied by an Epstein-Barr virus (EBV) or Kaposi’s sarcoma herpesvirus (KSHV) infection. Patients with primary effusion lymphoma have a worse prognosis than those without. However, chemotherapy increases the survival rate in patients with PEL.
The diagnosis of primary effusion lymphoma is made when AIDS patients with a malignant effusion within the body cavity are evaluated. The initial assessment is made by a cytopathology laboratory. The presence of KSHV-infected cells is an important determinant of the diagnosis. A biopsy may be performed when the presence of KSHV-infected lymphoid cells is seen.
Primary effusion lymphoma occurs in the pleural space or body cavities but is less common in other areas. Patients usually have a good prognosis when diagnosed before cancer develops. However, a high index of suspicion may be helpful in cases of malignant lymphoid effusion in a body cavity. The cytospin preparation shows a May-Grunwald-Giemsa stain. The cells are immature with a moderate amount of basophilic cytoplasm and obscure nucleoli. They are typically CD45-positive and have a null lymphocyte immunophenotype.
Primary effusion lymphoma has a predilection for the pleural space, but can also develop in the chest, abdomen, or pericardium. It is associated with Kaposi’s sarcoma-associated herpesvirus (KSHV) and Epstein-Barr virus (EBV). HHV8 sequences are commonly present in patients with AIDS-related body cavity-based lymphomas. Bortezomib (PS-341), a drug that inhibits the anti-herpes virus-associated effusion-based lymphoma virus, has antitumor effects in this disease. It is also associated with AIDS-related lymphomatous effusions.
Primary effusion lymphoma represents about four percent of all HIV-related NHLs. Treatment usually consists of CHOP chemotherapy. In addition, newer therapies incorporate augmented EPOCH regimens or axicabtagene ciloleucel. In addition, ganciclovir, an apoptotic agent, is sometimes used. A COX-2 selective inhibitor, nimesulide, is also used.
Primary effusion lymphoma may be treated with a combination of chemotherapy, including high-dose methotrexate. Apoptosis may be induced by zoledronic acid. Bortezomib (PS-341), an anti-herpes virus-associated effusion-based Lymphoma virus, has antitumor effects and has been studied for the treatment of primary effusion lymphoma.
Hepatosplenic gamma/delta T-cell lymphoma
hepatosplenic gamma/delta T-cell lymphoma (HSGDTL) is a type of T-cell non-Hodgkin lymphoma. It is a rare disease that accounts for less than one percent of all non-Hodgkin lymphomas. It is typically seen in young adults. It is caused by the extranodal infiltration of mature malignant post-thymic T-lymphocytes.
The most common physical findings in HSGDTL patients are hepatosplenomegaly and pancytopenia. In addition, it is known to be associated with hemophagocytic syndrome. It is more common in patients who have received long-term immunosuppressive therapy.
Patients with HSGDTL usually show a rapid progression of the disease. In addition, patients may show a poor response to therapy. Chemotherapy is usually used as the mainstay of treatment. However, many patients experience relapse after first-line therapy. It is important to talk with your doctor about your treatment plan. He or she will discuss possible side effects and how to best manage them.
In addition, it is important to understand that HSGDTL is a chronic immune suppressive disease. Patients may experience a bleeding diathesis, which can be caused by a deficiency in coagulation factors. Anemia may also be a problem. This may be due to infiltration of the bone marrow, as well as cytokines. Cytokines are proteins that help the body produce various cytokines, such as interleukin 2. These cytokines can also help the body to produce cytolytic activity.
A diagnosis of HSGDTL can be made using a biopsy. This can be performed on the spleen, liver, or bone marrow. It is done under a local anesthetic. The doctor will review the biopsy findings and decide on the best course of treatment.
Other tests that may be used for diagnosing HSGDTL are cytogenetics. In addition, patients may undergo immunohistochemical analysis. These tests will show gamma/delta T-cell receptor (TCR) expression and the expression of the gamma/delta T-cell karyotype.
In addition, a bone marrow biopsy can be performed, which will show the sinusoidal distribution of neoplastic T cells. It is important to note that HSGDTL can occur in patients who have undergone an organ transplant. There are cases where this disease has been associated with azathioprine therapy.
Hepatosplenic gamma/delta lymphoma is a rare and aggressive type of T-cell lymphoma. It occurs in young adults and is associated with hepatosplenomegaly.
Burkitt lymphoma
Amongst non-Hodgkin’s lymphomas, Burkitt lymphoma is one of the most aggressive. It is also one of the fastest-growing cancers. It is usually characterized by large tumors. It can also spread to the central nervous system (CNS) and bone marrow.
Burkitt lymphoma is usually treated with a combination of chemotherapy and targeted therapy. Chemotherapy kills a large number of cancer cells in a short period of time. The goal of treatment is to eliminate cancer.
Chemotherapy is usually administered in a hospital setting. Some hospitals offer ambulatory chemotherapy, which means that patients will wear a special pump during treatment. Patients can then call the hospital if they have any concerns or need to get blood tests or check-ups.
Burkitt lymphoma treatments depend on the patient’s risk for the disease. Some patients may be treated with immunosuppressive drugs to prevent recurrences. Others may be treated with chemotherapy and radiation therapy.
The best results are obtained with an intensive course of chemotherapy. A stem cell transplant can also be used to treat the disease. However, this procedure is most effective if the patient has a partial response to salvage therapy. Several types of chemotherapy are used for Burkitt lymphoma, including doxorubicin, vincristine, and cyclophosphamide.
In addition to chemotherapy, patients may also receive CNS prophylaxis. This is to prevent cancer from spreading to the brain and spinal cord. Burkitt lymphoma is also associated with the human immunodeficiency virus (HIV). Anti-HIV medications are sometimes used in combination with chemotherapy.
Burkitt lymphoma can be treated with a stem cell transplant. In some cases, patients can be given growth factors to help shorten the time they are in neutropenia.
Some patients may also be given chemotherapy drugs that are injected directly into the spinal fluid. This can help the doctor to determine if cancer has spread to other parts of the body. It can also help prevent tumor lysis syndrome, a condition where a large number of cancer cells are killed in a short period of time. This can cause problems with the nervous system and kidneys.
Burkitt lymphoma treatment depends on the type of cancer and the patient’s risk for the disease. However, the outlook for most people with Burkitt lymphoma is good. The outlook for younger adults is particularly good. It is also very rare for a person to relapse.
Treatment options
Whether you are a patient with non-Hodgkin lymphoma, or you are a healthcare professional who wants to help someone who has the disease, it is important to understand your options. Treatment depends on the stage of the disease, as well as the type of lymphoma.
Treatment options for non-Hodgkin lymphoma can include chemotherapy, radiation therapy, surgery, or a combination of these treatments. Some patients may be eligible for clinical trials, which can provide access to new treatments.
Chemotherapy for non-Hodgkin lymphoma typically involves a combination of drugs taken together in a prescribed regimen. Some drugs are given orally, while others are given intravenously. Chemotherapy can help to slow down the disease, prevent a recurrence, and treat symptoms.
Radiation therapy may be used in combination with chemotherapy, as well as to relieve pain caused by enlarged lymph nodes. However, it can also cause infertility and organ damage.
Stem cell transplant is an uncommon treatment method, but it may be used to treat certain forms of non-Hodgkin lymphoma. The stem cells are harvested from a donor’s body, or taken from the patient’s own body. In engraftment, the stem cells begin to produce new blood cells.
Patients can also take monoclonal antibodies to target lymphoma cells. These antibodies can be taken in combination with chemotherapy or radiation therapy. In some cases, the patient may also be put on an anti-viral drug.
Patients who are at risk for non-Hodgkin lymphoma should avoid certain infections, such as HIV. This condition can weaken the immune system and increase the risk of cancer. It is also important to note that some vaccines are not recommended for immunosuppressed people.
A patient’s age and overall health may affect his or her treatment options. Treatments can begin only after tests indicate that the lymphoma is progressing. Patients can ask their doctors about the risks associated with clinical trials.
Treatment options for non-Hodgkin’s lymphoma vary based on the stage of the disease, the type of lymphoma, and the patient’s overall health. The patient will also have to consider the side effects of the treatment.
Non-Hodgkin lymphoma treatment options include surgery, radiation therapy, chemotherapy, and biological therapy. Surgery may be used to remove part of a suspected mass, while radiation therapy may be used to destroy the lymphoma cells.
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