Lymphoma is a type of blood cancer than affects the white blood cells of the lymphatic system. The lymphatic system comprises of a network of lymph vessels that carry the lymph that helps in combating infections and certain precancerous cells.White blood cells known as lymphocytes are the main components of the lymph. Lymphoma develops when the lymphocytes are transformed into cancer cells that proliferate uncontrollably. The multiplying cancer cells accumulate to form tumors in one or multiple lymph nodes or lymph tissues. The cancer spreads to other lymph nodes and tissues, and to other organs of the body.
Lymphoma is classified into two categories – Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. These two types of lymphomas are further divided into more subtypes. Although different types of lymphomas may originate in the same place and exhibit similar symptoms, they have different appearances and molecular and genetic markers.The goal of lymphoma treatment is killing the malignant cells and preventing cancer recurrence. Chemotherapy and radiation therapy are the standard treatment options. Biological therapy is often used as an adjunct to conventional treatments for stimulating the natural ability of the body to fight cancer.
Treatments for Lymphoma
Radiation therapy is usually used as a first line therapy for lymphoma. Short bursts of high-energy rays are used to kill the cancer cells in the affected lymph node or tissue. The treatment may last for several weeks. Adverse reactions of radiation therapy are minimized by administering low doses of radiation during each radiation therapy session.Nausea, fatigue, diarrhea, skin problems and loss of appetite are common side effects of radiation therapy. Radiation may damage the bone marrow and decrease blood count. It may suppress the immune system, thereby increasing the risk of infections.
Chemotherapy is the most effective treatment for lymphoma. Multiple cytotoxic drugs are used for killing the lymphoma cells. Different types of chemotherapy drugs follow different mechanisms for killing the cancer cells. They are taken orally or administered intravenously.Chemotherapy with a single drug is rarely used for treating lymphoma. Combination therapy with multiple drugs is most effective in treating the disease. As lower doses of individual drugs are used in combination therapy, there is lower risk of developing side effects. Moreover, combination therapy is usually tolerable.
Combining chemotherapy drugs with steroids increases the effectiveness of chemotherapy treatment for lymphoma. Steroids commonly used for treatment include prednisolone, methylprednisolone and dexamethasone. They are taken orally or injected.Steroids may cause side effects such as appetite changes, indigestion, mood changes and sleeping difficulties that subside naturally after stopping the drugs.
Biological Therapy With Monoclonal Antibodies
Biological therapy with monoclonal antibodies works by stimulating the immune system. Rituximab is the most popular monoclonal antibody used in lymphoma treatment. It kills the lymphoma cells by targeting proteins called CD20 present on the surface of the mature lymphoma cell.Rituximab is administered through drip. It may cause mild side effects such as fever, rash and headache. In a small number of cases, treatment with rituximab causes wheezing and low blood pressure. Other monoclonal antibodies recommended for lymphoma treatment include tositumomab, epratizumab and alemtuzumab.
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