What Is Lymphoma? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Types of Lymphoma

Non-Hodgkin Lymphoma

• B Lymphocytes (B Cells) These cells make antibodies to fight infections. Most NHL is caused by B cells.
• T Lymphocytes (T Cells) T cells have several roles, including helping B cells make antibodies and fighting viruses.

They typically develop in the lymph nodes and lymphatic tissue but can sometimes affect bone marrow and blood. Some NHLs are slow-growing, while others can be aggressive. Your treatment options will depend on the type of NHL you have and how advanced it is.

• Diffuse Large B-Cell Lymphoma (DLBCL) This is the most common type of lymphoma, accounting for about 1 in 3 lymphomas. It’s often aggressive but responds well to treatment. DLBCL mostly impacts older adults, though there are several subtypes, including primary mediastinal B-cell lymphoma, which primarily affects young women.
• Follicular Lymphoma This accounts for about 1 in 5 lymphomas in the United States. These NHLs are typically slow-growing, although some can be aggressive. This type of lymphoma is rare in younger people and is difficult to cure, though patients often live for many years with it. Some follicular lymphomas can turn into fast-growing DLBCL.
• Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL) These are closely related, often slow-growing diseases. Many people with CLL and SLL live long lives. The main difference between the two conditions is that when the cancer cells are found primarily in the lymph nodes, doctors call it SLL. If the cancer cells are found mostly in the bloodstream and bone marrow, it is diagnosed as CLL. It is most common in older adults.
• Mantle Cell Lymphoma (MCL) MCL is much more prevalent in men than in women. It’s also more likely to affect older people and is challenging to treat. This type accounts for about 5 percent of lymphomas.

Some rarer types of NHL include:

• Cutaneous T-cell lymphomas
• Cutaneous B-cell lymphomas
• Primary central nervous system lymphoma
• Waldenstrom macroglobulinemia
• Burkitt lymphoma

Hodgkin Lymphoma

This form of lymphoma can spread from one lymph node to another.

Hodgkin lymphoma is most common in people in their early twenties and those over age 55, but it can affect adults and children of any age.

There are two main types of Hodgkin lymphoma: Classical and nodular.

• Nodular sclerosis Hodgkin lymphoma
• Mixed cellularity Hodgkin lymphoma
• Lymphocyte-rich Hodgkin lymphoma
• Lymphocyte-depleted Hodgkin lymphoma.

Nodular Lymphocyte Predominant Hodgkin Lymphoma This rare type of Hodgkin lymphoma leads to abnormally large cells that look like popcorn. It usually starts in the lymph nodes of the neck and underarms.

Signs and Symptoms of Lymphoma

Symptoms of Hodgkin lymphoma and non-Hodgkin lymphoma can vary depending on what area of the body is affected and how fast the cancer is growing. To further complicate the issue, some symptoms are not specific to lymphoma — they can resemble those of many less serious illnesses. Patients with Hodgkin and non-Hodgkin lymphoma often present to the doctor’s office thinking they have a cold, flu, or another persistent respiratory infection.

• Swelling, or feeling a lump in the lymph nodes of the neck, armpit, or groin area — these are generally persistent but don’t cause pain
• A fever higher than 103 degrees F (39.5 degrees C) that lasts for two days or longer, or gets better and then comes back
• Drenching and intense night sweats
• Unexplained or unwanted weight loss
• Ongoing fatigue
• Pain in the chest, abdomen, or bones
• Coughing or shortness of breath

Causes and Risk Factors of Lymphoma

• You have a family history of lymphoma.
• You’ve had certain viruses, such as human immunodeficiency virus (HIV) or Epstein-Barr virus.
• You have a compromised or weak immune system, for example, after taking immunosuppressant medications following an organ transplant.
• You’ve had chemotherapy or radiation therapy in the past.

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How Is Lymphoma Diagnosed?

The diagnosis of lymphoma begins with a physical exam, looking for swollen lymph nodes in the neck, underarm, groin, and elsewhere. Your doctor might then take a biopsy of a lymph node for laboratory analysis to determine whether the cells are characteristic of lymphoma. This is a sample of cells they sent to a lab for examination under a microscope.

Doctors can also take a sample of bone marrow from your hip bone to look for lymphoma cells. They may also order computed tomography, magnetic resonance imagine, or positron emission tomography scans to look for signs of lymphoma elsewhere in the body.

Lymphoma Prognosis

The five-year survival rate describes the percentage of people who are alive at least five years after a cancer diagnosis, compared with those who do not have cancer. It’s important to remember that survival rates are only estimates. Your outlook will depend on several factors, including the type of lymphoma you have and how aggressive your disease is, as well as your age and general health.

Treatment and Medication Options for Lymphoma

Treatment options differ between non-Hodgkin and Hodgkin lymphomas, and treatment will also depend on the stage of the cancer, among other factors. However, people with lymphoma have a wide array of treatment options available, and many are highly effective at curing certain types of lymphoma.

Once your doctor has classified the type of lymphoma, you and your doctor must consider a broad array of possible treatments, each with its own benefits and risks. They may recommend a single treatment or a combination of treatments.

Medication Options

• Chemotherapy This uses strong drugs to kill cancer cells or prevent cancer cell growth, and it is one of the main treatments for NHL.

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  Often, people with lymphoma receive these drugs through an intravenous drip. Chemotherapy can cause strong side effects, like anemia, nausea, vomiting, and hair loss, as it can also damage normal cells.
• Immunotherapy During immunotherapy, medication helps the immune system recognize and eliminate cancer cells. Normally, cancer cells can disguise themselves from your immune system, but immunotherapy can help your body detect and destroy them.
• Targeted Therapy These types of medications target proteins or changes in some lymphoma cells but don’t harm healthy ones. A doctor may recommend targeted therapy if your cancer cells have certain characteristics that medications can target.
• Steroids These can help make chemotherapy more effective and help your body produce more white blood cells. Doctors might recommend this if you have diffuse large B-cell lymphoma.

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Chimeric Antigen Receptor (CAR) T-Cell Therapy

Radiation Therapy

A doctor may also recommend radiation therapy to shrink a lymphoma and reduce symptoms such as pain.

Bone Marrow Transplants

Some types of bone marrow transplants, known as autologous transplants, use the body’s own tissue to create stem cells. Others, called allogeneic transplants, may come from a donor.

Lifestyle Changes for Lymphoma

Reduce Your Risk of HIV and Hep C

Look After Your Body Weight and Diet

Be Aware of Breast Implant Risks

Complications of Lymphoma

• Heart disease
• Secondary cancers (elsewhere in the body)
• Lung and bone health
• Cognitive and memory problems
• Hormone and thyroid changes
• Long-term fatigue

Disparities and Inequities in Lymphoma

While non-Hispanic white Americans have the highest risk of both getting and dying from lymphoma, studies have shown that Black populations face challenges around lymphoma treatment, including getting diagnosed at younger ages and facing barriers to accessing high-intensity treatments.

A complex range of social and biological factors may contribute to these disparities. Further research is necessary to explore why they affect treatment outcomes and how to improve them.