Non-Hodgkin’s lymphoma

Non-Hodgkin's lymphoma is a type of cancer that begins in the lymphatic system and is the part of the body’s immune system fighting germs. In non-Hodgkin’s lymphoma, white blood cells called lymphocytes grow abnormally and can form growths (tumors) throughout the body.

Non-Hodgkin’s lymphoma is a general category of lymphoma. Many subtypes fall in this category. Diffuse large B-cell lymphoma and follicular lymphoma are among the most common subtypes. The other general category of lymphoma is Hodgkin’s lymphoma.

Symptoms                             

Signs and symptoms of non-Hodgkin's lymphoma may include:

• Swollen lymph nodes in your neck, armpits or groin;
• Abdominal pain or swelling;
• Chest pain, coughing or trouble breathing;
• Persistent fatigue;
• Fever;
• Night sweats;
• Unexplained weight loss

When to see a doctor                                                           

Make an appointment with your doctor if you have any persistent symptoms worrying you.

Causes                               

In most cases, doctors do not know what causes non-Hodgkin’s lymphoma. It begins when your body produces abnormal lymphocytes, which are a type of white blood cell.

Normally, lymphocytes go through a predictable life cycle. Old lymphocytes die and the body creates new ones to replace them. In non-Hodgkin’s lymphoma, your lymphocytes do not die, and your body continues to creating new ones.

An excessive number of lymphocytes accumulates into your lymph nodes, causing them to swell.

Risk factors                                                           

Some factors that may increase the risk of non-Hodgkin’s lymphoma include:

Medications that suppress your immune system. If you have had an organ transplant and take medicines that control your immune system, you may have an increased risk of non-Hodgkin’s lymphoma.

Infection with certain viruses and bacteria. Certain viral and bacterial infections increase the risk of developing non-Hodgkin’s lymphoma. Viruses related to this type of cancer include HIV and Epstein-Barr infection. Bacteria link related to non-Hodgkin’s lymphoma include the ulcer-causing Helicobacter pylori.

Chemicals. Certain chemicals may increase your risk of developing non-Hodgkin’s lymphoma. More research is needed to understand the possible link between pesticides and the development of non-Hodgkin’s lymphoma.

Older age. Non-Hodgkin’s lymphoma can develop at any age, but the risk increases with age. It’s most common in people over 60.

Treatment                             

If non-Hodgkin’s lymphoma is aggressive or causes signs and symptoms, your doctor may   consider the following treatment options:

Chemotherapy

Chemotherapy is a drug treatment that kills cancer cells. It can be taken orally or by injection. Chemotherapy drugs can be used alone or in combination with other chemotherapy drugs.

For people with non-Hodgkin’s lymphoma, chemotherapy is also used during bone marrow transplant, also known as a stem cell transplant. High doses of chemotherapy drugs can help prepare your body for the transplant.

Radiation therapy

Radiation therapy uses high-powered energy beams, such as X-rays and protons. For certain types of non-Hodgkin’s lymphoma, radiation therapy may be the only treatment, particularly if your lymphoma is growing slow and located in just one or two places. More commonly, radiation is used to kill any lymphoma cells that might remain after chemotherapy. Radiation may be aimed at affected lymph nodes and the nearby area of nodes where the disease is progressing.  

 Targeted drug therapy

Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatment can cause cancer cells to disappear.

For non-Hodgkin’s lymphoma, targeted drugs can be used alone, but are often combined with chemotherapy.

Engineering immune cells to fight lymphoma

A specialized treatment called chimeric antigen receptor (CAR)-T cell therapy takes your body’s germ-fighting T cells, engineers them to fight cancer and infuses them back into your body. CAR-T cell therapy might be an option for certain types of B-cell non-Hodgkin’s lymphoma that do not respond to other treatments.

Bone marrow transplant

Bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress your bone marrow and immune system. Then healthy bone marrow stem cells from your body or from a donor are infused into your blood where they spread to your bones and regenerate the bone marrow.

Immunotherapy

Immunotherapy uses your immune system to fight cancer. The disease-fighting immune system may not attack the cancer because the cancer cells produce proteins that help them hide from the immune system cells.