From the Guidelines
Lymphoma symptoms typically include B symptoms such as fever, drenching night sweats, and unexplained weight loss > 10% over 6 months, as well as other disease-related symptoms like fatigue, pruritus, and alcohol-induced pain. These symptoms are crucial in the diagnostic work-up and staging of lymphoma, as outlined in the ESMO clinical practice guidelines for diagnosis, treatment, and follow-up 1. The medical history, including the presence of these symptoms, should be recorded, along with the results of a physical examination.
Key Symptoms
- Fever
- Drenching night sweats
- Unexplained weight loss > 10% over 6 months
- Fatigue
- Pruritus
- Alcohol-induced pain Other symptoms may include persistent swollen lymph nodes, usually painless, in the neck, armpits, or groin, as well as shortness of breath or chest pain if lymph nodes in the chest are affected, and abdominal pain or swelling if lymphoma affects organs like the spleen or liver.
Diagnostic Work-up
The diagnostic work-up for lymphoma includes a chest X-ray, a contrast-enhanced computed tomography (CT) scan of the neck, chest, and abdomen, and a baseline whole-body positron emission tomography (PET) scan, if available 1. Full blood cell count, erythrocyte sedimentation rate (ESR) testing, and blood chemistry analysis, including C-reactive protein (CRP), alkaline phosphatase (AP), lactate dehydrogenase (LDH), liver enzymes, and albumin, are also obligatory. Screening for hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) is compulsory 1. Given the high sensitivity of PET–CT for bone marrow involvement, a bone marrow biopsy is no longer indicated in patients undergoing PET–CT evaluation [III, B] 1, but it must be carried out if PET–CT is not available.
From the FDA Drug Label
In approximately 1% of the lymphoma patients treated with Bleomycin for Injection, an idiosyncratic reaction, similar to anaphylaxis clinically, has been reported A severe idiosyncratic reaction consisting of hypotension, mental confusion, fever, chills, and wheezing has been reported in approximately 1% of lymphoma patients treated with Bleomycin for Injection. A severe idiosyncratic reaction (similar to anaphylaxis) consisting of hypotension, mental confusion, fever, chills, and wheezing has been reported in approximately 1% of lymphoma patients treated with bleomycin.
The symptoms of lymphoma that are mentioned in the context of bleomycin treatment are:
From the Research
Lymphoma Symptoms
- Lymphoma typically presents as painless adenopathy, with systemic symptoms of fever, unexplained weight loss, and night sweats occurring in more advanced stages of the disease 3
- These symptoms are used in the Lugano classification system to stage lymphoma, which is then used to determine treatment 3
- The staging of lymphoma also incorporates the extent of the disease as shown on positron emission tomography/computed tomography (PET/CT) scans 4
Diagnosis and Treatment
- An open lymph node biopsy is preferred for diagnosis 3
- Chemotherapy treatment plans differ between the main subtypes of lymphoma, with non-Hodgkin lymphoma treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (R-CHOP), bendamustine, and lenalidomide, and Hodgkin lymphoma treated with combined chemotherapy with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), Stanford V, or BEACOPP with radiotherapy 3