See also antibodies as specific cancer treatment
Hodgkin’s Lymphoma:
Hodgkin’s lymphoma usually arises in the lymph nodes of young adults. It can be divided into classical subtype and a less common nodular lymphocytic predominant subtype. The most common features at presentation are painless enlargement of lymph nodes, usually in the neck, but occasionally in the inguinal region.
The difference between non-hodgkin’s and Hodgkin’s lymphoma is that Hodgkin’s requires the presence of a specific type of abnormal cell called a Reed-Sternber cell. RS express CD15, CD25, CD30 and transferrin receptor. In most cases, the RS cells do not express CD45, a feature that aids in distinguishing this disease form NHL. Epstein Barr virus has been shown to be present in RS in about 1/3 of hodgkin’s lymphoma but its role is unclear.
Non-Hodgkin’s Lymphoma:
Non-Hodgkin’s lymphoma (NHL) are a large group of cancesr which starts in lymphocytes. RITUXAN (Genentech) have been used successfully to treat non-Hodgkin’s lympoha. HERCEPTIN is a recombinant DNA dervied humanized monoclonal antibody that selectively binds to the extracellular domain of the human epidermal growth factor receptor 2 (HER2) proto-oncogene. HER2 protein overexpression is observed in 25-30% of primary breast cancers. RITUXAN is a genetically engineered chimeric murine/human monoclona antibody directed against the CD20 antigen found on the surface of normal and malignant B lymphocytes. NHL is much more common than Hodgkin’s and in the US is the sixth most common cancer amoung males and the fifth most common cancer amoung females.
Acute (B Cell) lymphocytic leukemia (ALL): is a bone marrow based neoplasm largely affecting children between 1-5. Most common symptoms include fatigue, lethargy, fever and bone and joint pain. Precise diagnosis relies on a bone aspirate and biopsy. The demonstration of lymphoblasts in the bone marrow is diagnostic of ALL.
B cell prolymphocytic leukemia (PLL): once a variant of CLL is a distinct disease of elderly men and characterized by a very high white blood count (greater than 200.times.10.sup.9/L) and splenomegaly. Additional symptoms include anemia and thrombocytopenia.
Burkitt’s Lymphoma: is an aggressive B cell lymphoma typically observed in children and young adults and is usually assocaited with builky disease of the jaw and/or abdomen. About 20% of patients have bone marrow involvement. An endmic form of Burkitt’s lympohma involves Epstein-Barr virus (EBV) infection of malignant cells.
Chronic lymphocytic leukemia (CLL)/Small B cell lymphocytic lymphoma (SLL): is the most common type of leukemia. When the disease involves the periopheral blood and bone marrow it is referred to as Cll. However, when the lymph nodes and other tissues are infiltrated by cells that are identical to those in CLL, but where leukemic characteristis of the disease are absent, it is referred to as SLL. This dsease largely afflicts the elderly with a greater incidence in men. Painless lymphadenopathy is the most common finding at presentation. Asymptomatic patients are frequently diagnosed during routine blood coutns (lymphocyte count of over 5000.times.10.sup.9/L).
Cutaneous T-cell Lymphoma: is a type of non-Hodgin lymphoma. Mycosis Fungoides and Sezary syndrome are two of the most common cutaenous T cell lymphomas. A sign of mycosis fungoides is a red rash on the skin. Mycosis fungoides may go through a premycotic phase which includes a scaly, red rash in areas of the body not usually exposed to sun. This rash does not cause any symptoms a may last for years. a patch phase where there is a reddened eczema like rash. a plaque phase shown by small raised bumps or hardened lesions on the skin which may be redenned. a tumor phase. In Sezary syndrome cancerous T cells are found in the blood.
Diffuse Large B cell Lymphoma (DLBCL): is the most common NHL and can arise form small B cell lymphoma, folicular lymphoma or marginla zone lymphoma. Typcially, pateints present with lymphadenopathy; however, a large percent of patients present in extranodal sites as well, with gastrointestinal involvement being the most common.
Extranodal marginal zone lymphoma: is an extranodal lymphoma that occurs in organs normally lacking organized lymphoid tissues (e.g., stomach, salivary glands, lung and thyroid glands). It largely affects older adults over 60. Often, chronic inflammation or autoimmune processes precede development of the lymphoma. Gastric mucosal associated lympohic tissue (MALT) lymphoma, the most common type of marginal-zone lymphoma, is associated with Helicobacter pylori infection. Studies have shown a resuolution of symptoms with eradication of the H. plori infection following an antibiotic regimen. Symptoms for gasric MALT lymphoma include epigastric pain, nausea, gastrointestinal bleeding and anemia.
Follicular lymphoma (FL): is a slow-growing, chronic, and usually incurable type of non-Hodgkin lymphoma (NHL) that affects white blood cells called B-lymphocytes. It’s the second most common type of NHL, accounting for 20–30% of all cases. FL occurs when white blood cells clump together to form lumps in the lymph glands or organs.
Follicular lymphoma can progress very slowly – so slowly that at first you may not need treatment. This is especially true if you have fewer or smaller tumors (“low tumor burden”) and you don’t have any symptoms. Studies suggest to start treatment if your lymph nodes get larger, you experience fever and night sweats or you have low blood counts.
Follicular lymphoma is hard to cure. Treatment keeps symptoms under control and can keep the cancer at bay for years at a time. But many people eventually relapse, and it can happen more than once. If your disease progresses after one type of treatment, your doctor will recommend that you move onto another.
Hairy Cell Leukemia (HCL): is a rare, indolent chronic leukemia affecting more men than women and largely those of middle age. Symptoms include massive splenomegaly and pancytopenia. The periopheral blood and bone marrow contain the typical “hairy cells” which are B lymphoctyes with cytoplasmic projections.
Nodal marginal zone lymphoma: has a heterogeneous cytology and morphology. Due to its relatively high proportion of large cells this lymphoma, unlike the other marginal lymphomas (splenic and extranodal) cannot be classified as true low grade B cell lymphoma.
Splenic Marginal Zone Lymphoma: is an indolent micro-nodular B cell lymphoma with a prominnet splenomegaly and infiltration of the peripheral blood and the bond marrow.