Understanding Lymphoma

What is Lymphoma?

Lymphoma is a type of hematological cancer that originates in the lymphatic system, which includes lymph nodes, the spleen, liver, thymus, tonsils, and bone marrow. It arises from lymphocytes—a type of white blood cell (B cells, T cells, and NK cells)—which circulate through the blood and lymphatic system and reside in various organs, including the skin, stomach, intestines, brain, eyes, and lungs. Lymphoma begins when healthy lymphocytes undergo abnormal changes and grow uncontrollably.

Symptoms of Lymphoma

Lymphoma symptoms vary based on the stage, organ involvement, type, growth rate, and overall health of the patient. Common signs include:

B symptoms: Unexplained fever, night sweats, and unintentional weight loss.
Swollen lymph nodes: Typically in the neck, armpits, or groin.
Blood abnormalities: Low hemoglobin (Hb), white blood cell (WBC), and platelet counts.
Non-specific symptoms: Fatigue, persistent infections, or generalized malaise, often mistaken for common ailments like tuberculosis, leading to delayed diagnosis.

Diagnosing Lymphoma

A detailed analysis of the affected organ is key to both diagnosis and treatment planning. The most commonly affected organ is the lymph node, and an excisional biopsy (complete removal) is ideal for accurate diagnosis.

Peripheral lymph nodes: Easily removed through minor surgery.
Deeper lymph nodes: Require CT- or ultrasound-guided core biopsy or, in difficult cases, fine-needle aspiration cytology (FNAC).
PET-CT scans: Helpful in staging but do not diagnose lymphoma.
Bone marrow biopsy: Used selectively for staging or specific lymphoma subtypes.

Treatment Options for Lymphoma

Lymphoma treatment depends on the subtype, stage, and patient condition. Common approaches include:

Chemotherapy – Traditional anti-cancer drugs.
Immunotherapy – Boosts the immune system to target lymphoma cells.
Targeted therapy – Precision drugs aimed at specific cancer cell markers.
CAR T-cell therapy – Genetically modified immune cells to fight cancer.
Stem cell transplant – Used in relapsed or high-risk cases.
Reducing immunosuppressive therapy – Beneficial in some cases.
Antiviral therapy – Effective in virus-related lymphomas, avoiding chemotherapy toxicity.
Managing Treatment Side Effects
Healthy lifestyle: Balanced nutrition and regular exercise.
Medical support: Open communication with your doctor and team.
Recognizing red flags: Immediate attention to severe fatigue, infections, or bleeding.

Types of Lymphoma

There are nearly 90 subtypes of lymphoma, but they fall into two broad categories:

Hodgkin Lymphoma (HL) – Less common, often in younger patients.
Non-Hodgkin Lymphoma (NHL) – More common, further classified by cell type:
B-cell NHL (most common)
T-cell NHL
NK-cell NHL

Lymphomas can also be categorized based on growth rate:

Low-grade (indolent) lymphoma – Slow-growing, may not need immediate treatment.
High-grade (aggressive) lymphoma – Rapid-growing, requiring urgent therapy.
Fertility and Family Planning

Lymphoma treatments can affect fertility, but options exist for preservation. Patients should discuss fertility preservation with an oncologist and fertility specialist before starting treatment.

Post-Treatment Follow-Up

Regular follow-ups with a hematologist-oncologist are crucial to monitor remission, manage long-term side effects, and address life concerns like marriage and childbearing. Building a strong relationship with your care team ensures ongoing support.

Who is at Risk for Lymphoma?

Lymphoma risk is influenced by a combination of genetic and environmental factors, including:

Age: NHL is common in older adults; HL is more frequent in young adults.
Weakened immune system: HIV/AIDS, organ transplants, or autoimmune diseases.
Infections: Epstein-Barr virus (EBV), Helicobacter pylori, Hepatitis C.
Prior cancer treatments: Radiation or chemotherapy for other cancers.
Chemical exposure: Pesticides, benzene, and other toxins.

However, many individuals with these risk factors never develop lymphoma. Ongoing research suggests an interplay between genetic predisposition and environmental triggers in disease development.