Non- Hodgkin’s Lymphoma Flashcards
What is the main distinction between Hodgkin’s Lymphoma (HL) and Non-Hodgkin’s Lymphoma (NHL)?
The presence of Reed-Sternberg cells distinguishes HL from NHL.
What happens if Reed-Sternberg cells are present?
The diagnosis of Hodgkin’s Lymphoma (HL) is made.
How are lymphomas classified?
All lymphomas other than HL are classified under the Non-Hodgkin’s Lymphoma (NHL) category.
Where can Non-Hodgkin’s Lymphoma occur?
NHL can occur anywhere the lymph fluid travels, including lymph nodes and extranodal sites.
How does Non-Hodgkin’s Lymphoma spread?
NHL spreads randomly and can involve multiple sites.
What factors influence the prognosis of Non-Hodgkin’s Lymphoma?
The prognosis of NHL depends on specific histologies.
What is the demographic predominance of Non-Hodgkin’s Lymphoma?
NHL predominantly affects white males aged 65-74 years.
Who is more likely to develop NHL?
People with immune system deficiencies, autoimmune diseases, and chronic infections are more likely to develop NHL.
For example, patients with immunosuppression who are awaiting organ or bone marrow transplants are at an increased risk.
Which viruses or diseases increase the risk of NHL?
AIDS, Burkitt’s Lymphoma (EBV), Hepatitis C, T-lymphotropic virus type 1 (HTLV-1), and certain bacteria like Helicobacter pylori increase the risk.
How does occupational exposure relate to NHL risk?
Overexposure to certain chemicals, most often occupation-related, increases risks.
What are the symptoms of NHL?
Symptoms mimic those for HL: enlarged lymph nodes, night sweats, weight loss, fever, and itching.
Where does NHL typically occur?
NL occurs in lymph nodes but is also found in a wide variety of locations in the body.
What is the most common site for extranodal involvement in NHL?
The most common site for extranodal involvement is the gastrointestinal (GI) system, more specifically the stomach.
What are other common sites for NHL involvement?
Other common sites include: Waldeyer’s ring, skin, bone marrow, sinuses, thyroid, large vessels, CNS, and genitourinary system (GU).
What imaging studies are helpful in assessing NHL?
X-ray, CT, PET, MRI, and US are helpful in the assessment of the extent of disease and in the initial stage.
What abnormalities may be present in lab studies for NHL?
Lactic acid dehydrogenase and calcium levels may be abnormal.
What types of biopsies are used for NHL diagnosis?
Lymph node and bone marrow biopsy are used for NHL diagnosis.
What are the two main groups of NHL?
The two main groups are B Cell Lymphomas and T Cell Lymphomas.
What percentage of NHLs are B Cell Lymphomas?
B Cell Lymphomas account for 85% of NHLs.
What are examples of B Cell Lymphomas?
Examples include diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, and Burkitt lymphomas.
What types of T Cell Lymphomas exist?
Types include peripheral T-cell lymphoma, cutaneous T-cell lymphoma
NHL can either be _____ or ______.
Indolent
Aggressive
What are the indolent NHLs?
Nodular and follicular
What staging system is most often used for NHL?
The Ann Arbor staging system is most often used for NHL.
What is other staging system is used for grading NHL?
The Revised European American Lymphoma Classification (REAL) is used for grading NHL.
What are the grades of NHL?
NHL is graded as Low grade, Intermediate Grade, and High Grade.
What characterizes low grade NHL?
Indolent, slow growing cancers are low grade but tend to recur more over time.
What characterizes high grade NHL?
Aggressive tumors are referred to as high grade and grow at a much faster rate.
Can aggressive tumor cells be curable?
Although aggressive tumor cells multiply more quickly than indolent lymphomas, they are often just as curable.
What is the treatment of choice for NHL?
Chemotherapy
CHOP
What does the CHOP regimen consist of?
Cyclophosphamide, doxorubicin, vincristine, prednisone
How can indolent NHL in stages I or II be treated?
With radiation alone
What is the purpose of immunotherapy with rituximab?
To boost the immune system into fighting off cancer cells
Who can benefit from a stem cell transplant?
Patients with advanced or recurrent disease
What is the treatment approach for aggressive lymphomas?
Chemo and radiation combined
What is included in radiation therapy treatment for NHL?
The involved site along with the related drainage nodal clusters nearby.
What is the typical dose for radiation therapy in NHL?
Treatment fields are treated to a dose of 35-45 Gy.
What is testicular shielding used for?
Testicular shielding may be used in the treatment of pelvic and abdominal lymph nodes to preserve fertility in males.
What procedure can females undergo to protect their ovaries during treatment?
Females can have an oophoroplexy done to move the ovaries out of the area of treatment.
How does prognosis differ between men and women with NHL?
Men have a slightly worse prognosis than women.
What is the prognosis for children diagnosed with NHL?
Children generally have a good prognosis with this disease.
What is the cure rate for early-stage NHL?
With early-stage disease, there is a 90% cure rate.
What is more dependent on histology, NHL or Hodgkin lymphoma?
Prognosis for NHL is more dependent on histology than is Hodgkin lymphoma.
What characterizes indolent lymphoma?
An indolent lymphoma is slow-growing and causes little problems at the time of diagnosis.
What is the median survival time for indolent lymphoma?
The median survival time is from 10 to 20 years, depending on advancement.
What is the overall 5-year survival rate for aggressive NHL?
Aggressive NHL has an overall 5-year survival rate of 60%.
When is the risk of relapse highest for both indolent and aggressive NHL?
The risk of relapse is the highest after the first 2 years of treatment.
