From the Guidelines
Lymphatic cancer, also known as lymphoma, is a type of cancer that affects the immune system, specifically the lymphatic cells, and is characterized by the uncontrolled growth of malignant cells in the lymph nodes, spleen, or other lymphoid tissues.
Types of Lymphoma
- Non-Hodgkin's lymphoma (NHL): a heterogeneous group of lymphoproliferative disorders originating in B lymphocytes, T lymphocytes, or natural killer cells, with follicular lymphoma (FL) being the most common subtype of indolent NHL, accounting for approximately 22% of all newly diagnosed cases of NHL 1.
- Hodgkin lymphoma: characterized by a very good prognosis and a significant cure rate with ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)-type chemotherapy 1.
Characteristics of Lymphoma
- Indolent or aggressive: lymphomas can be described as indolent or aggressive, depending on their clinical course and prognosis, with indolent lymphomas, such as FL, having a course characterized by multiple relapses and progressive chemoresistance, and eventually dying of their disease 1.
- Prognosis: depends on histologic type, stage, age, and treatment, as well as tumor environment, presence of infectious agents associated with lymphomagenesis, and molecular events involved in cell proliferation, differentiation, and apoptosis 1.
Treatment and Management
- Rituximab: an anti-CD20 monoclonal antibody that has significantly improved the prognosis of NHL of B-cell origin, particularly when used in combination with chemotherapy 1.
- Radioimmunotherapy: has provided an important advance in the treatment of advanced or refractory NHL, with 90Y-ibritumomab tiuxetan (Zevalin) being the first radioimmunotherapy to be approved for use in malignant disease 1.
- Maintenance and consolidation therapy: with rituximab and radioimmunotherapy have also been associated with improved progression-free survival in patients experiencing response to first-line therapy 1.
From the Research
Definition and Classification of Lymphatic Cancer (Lymphoma)
- Lymphoma is a group of malignant neoplasms of lymphocytes with more than 90 subtypes, traditionally classified broadly as non-Hodgkin or Hodgkin lymphoma 2.
- Non-Hodgkin lymphoma accounts for approximately 90% of all lymphomas, while Hodgkin lymphoma accounts for around 10% 3.
- Lymphomas can be further divided into indolent and aggressive types, with different clinical management approaches 3.
Characteristics and Outcomes of Lymphoma
- Lymphoma can occur in patients over 90 years of age, with a median overall survival of 7.2 months for non-Hodgkin lymphoma patients 4.
- The prognosis of lymphoma varies depending on the type, with aggressive lymphomas being more dangerous if left untreated, but also more chemosensitive 3.
- Treatment administration can improve survival in patients with aggressive non-Hodgkin lymphoma, but not in those with indolent non-Hodgkin lymphoma 4.
Diagnosis and Treatment of Lymphoma
- Lymphoma typically presents as painless adenopathy, with systemic symptoms occurring in more advanced stages of the disease 2.
- An open lymph node biopsy is preferred for diagnosis, and the Lugano classification system is used to stage lymphoma 2.
- Chemotherapy treatment plans differ between non-Hodgkin and Hodgkin lymphoma, with common regimens including CHOP, R-CHOP, and ABVD 2.
- Diagnostic and predictive biomarkers are being developed to improve lymphoma diagnosis and treatment, enabling personalized therapy and precision medicine 5.