LYMPHOMAS 

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Q: What is lymphoma? 

A: Lymphoma is a type of blood cancer that starts in the lymphocytes, which are infection-fighting white blood cells. These cells are part of the lymphatic system, which includes the lymph nodes, spleen, thymus, and bone marrow. 

Lymphoma is categorized into two main types: 

1. Hodgkin Lymphoma (HL) – Distinguished by the presence of Reed-Sternberg cells (large abnormal B-lymphocytes). 

1. Non-Hodgkin Lymphoma (NHL) – A diverse group of lymphomas, accounting for ~82% of all lymphoma cases. 

Some lymphomas grow slowly (indolent) and may not require immediate treatment, while others are aggressive and need urgent treatment. 

 

Q: Who is at risk of developing lymphoma? 

A: The exact cause of lymphoma is unknown, but certain factors may increase risk: 

• Weakened immune system (e.g., HIV/AIDS, organ transplant patients). 

• Infections: 

• Epstein-Barr virus (EBV) – Linked to Hodgkin lymphoma and some NHLs. 

• Helicobacter pylori (H. pylori) – Linked to MALT lymphoma (a subtype of NHL). 

• Human T-cell leukemia virus (HTLV-1) – Linked to Adult T-cell leukemia/lymphoma. 

• Autoimmune diseases (e.g., lupus, rheumatoid arthritis). 

• Exposure to radiation or toxic chemicals (e.g., pesticides, benzene). 

• Age and gender: 

• HL is more common in young adults (15-40) and older adults (over 55). 

• NHL risk increases with age and is more common in men. 

• Family history: Having a first-degree relative with lymphoma slightly increases risk. 

 

Q: What are the signs and symptoms of lymphoma? 

A: Many symptoms are similar to infections, which can make early diagnosis difficult. Common signs include: 

• Swollen lymph nodes (often painless, in the neck, armpits, or groin). 

• Persistent fever. 

• Drenching night sweats. 

• Unexplained weight loss (>10% of body weight in 6 months). 

• Fatigue and weakness. 

• Itchy skin or rash. 

• Shortness of breath and cough (if lymphoma affects the chest). 

• Feeling of fullness or stomach pain (if spleen is enlarged). 

If symptoms persist for more than two weeks, see a doctor for further evaluation. 

 

Q: What tests are used to diagnose lymphoma? 

A: Diagnosis involves several tests, including: 

1. Lymph Node Biopsy – A sample of a swollen lymph node is examined under a microscope. Reed-Sternberg cells indicate Hodgkin lymphoma (HL). 

1. Blood Tests – Check for abnormal lymphocyte counts, lactate dehydrogenase (LDH) levels, and signs of infection. 

1. Bone Marrow Aspiration & Biopsy – Determines if lymphoma has spread to the bone marrow. 

1. Imaging Tests: 

1. CT scan or MRI – Detects enlarged lymph nodes and organ involvement. 

1. PET scan – Determines lymphoma activity and spread. 

1. Flow Cytometry & Immunophenotyping – Identifies specific lymphoma subtypes. 

1. Cytogenetic Testing & Molecular Testing – Detects genetic mutations that may guide targeted therapy decisions. 

 

Q: How is lymphoma treated? 

A: Treatment depends on the type, stage, and aggressiveness of the lymphoma. Some slow-growing lymphomas may not require immediate treatment (watch-and-wait approach). 

Hodgkin Lymphoma (HL) Treatment 

• Chemotherapy (main treatment): 

• ABVD regimen (Adriamycin, Bleomycin, Vinblastine, Dacarbazine) is commonly used. 

• BEACOPP regimen (more intensive) for advanced-stage HL. 

• Radiation Therapy: Often used after chemotherapy for localized HL. 

• Targeted Therapy (for relapsed or resistant HL): 

• Brentuximab vedotin (anti-CD30 antibody-drug conjugate). 

• PD-1 inhibitors (nivolumab, pembrolizumab) for refractory HL. 

• Stem Cell Transplantation: Used if lymphoma relapses after chemotherapy. 

• CAR-T Cell Therapy: Currently in clinical trials for relapsed HL. 

 

Non-Hodgkin Lymphoma (NHL) Treatment 

• Watch-and-Wait Approach: 

• Used for slow-growing lymphomas (follicular lymphoma, marginal zone lymphoma). 

• Chemotherapy (main treatment for aggressive NHL): 

• R-CHOP regimen (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) for Diffuse Large B-cell Lymphoma (DLBCL). 

• Targeted Therapy: 

• Rituximab (anti-CD20 antibody) for B-cell lymphomas. 

• Ibrutinib, Zanubrutinib, Acalabrutinib for Mantle Cell and CLL/SLL lymphomas. 

• CAR-T Cell Therapy: 

• Axicabtagene ciloleucel (Yescarta), Tisagenlecleucel (Kymriah), Brexucabtagene autoleucel (Tecartus) for relapsed/refractory B-cell NHL. 

• Stem Cell Transplantation: Used for aggressive lymphomas that relapse. 

• Immunotherapy: 

• Checkpoint inhibitors (pembrolizumab, nivolumab) for certain NHL subtypes. 

 

Q: What are the newest treatments for lymphoma? 

A: Some of the latest advancements include: 

• New CAR-T Cell Therapies for aggressive B-cell lymphomas. 

• Bispecific Antibodies: Mosunetuzumab, Epcoritamab – Engage the immune system to attack lymphoma cells. 

• Next-generation BTK Inhibitors: Pirtobrutinib (for CLL and mantle cell lymphoma). 

• Lenalidomide (Revlimid): Used for follicular lymphoma and mantle cell lymphoma. 

• Combination therapies: Targeted therapy + immunotherapy to improve remission rates. 

These newer treatments have improved survival rates and reduced chemotherapy side effects. 

 

Q: What are the survival rates for lymphoma? 

A: Prognosis depends on the type, stage, and response to treatment: 

• Hodgkin Lymphoma (HL): 

• Stage I-II: ~90% 5-year survival rate. 

• Stage III-IV: ~70-80% with proper treatment. 

• Non-Hodgkin Lymphoma (NHL): 

• Indolent NHL (Follicular, MALT lymphoma): ~85-90% survival rate. 

• Aggressive NHL (DLBCL, Mantle Cell Lymphoma): 50-70% survival rate with treatment. 

Survival rates continue to improve with newer therapies. 

  

Q: Can lymphoma be prevented? 

A: While there’s no definite way to prevent lymphoma, you can reduce risk by: 

• Avoiding infections (EBV, H. pylori, HIV). 

• Limiting exposure to radiation and chemicals. 

• Maintaining a healthy immune system (balanced diet, exercise). 

• Regular medical check-ups for early detection.