Lymphoma

Lymphoma (or lymphatic cancer) affects the lymphatic system which is the body’s germ-fighting network. This system includes the lymph glands and nodes, the spleen, the thymus gland and bone marrow. Although lymphoma mainly affects these parts of the body, it can also impact other organs.

Lymphoma starts when a disease-attacking white blood cell called a lymphocyte develops a genetic mutation. This mutation informs the cell to quickly multiply, causing numerous diseased lymphocytes to continue reproducing. The mutation will also let the cells to continue living while other normal cells would die, leading to an abundance of diseased and ineffective lymphocytes in your lymph nodes, spleen and liver to become enlarged.

Types of lymphoma

There are many types of lymphoma, including:

  • Chronic lymphocytic leukaemia
  • Cutaneous B-cell and T-cell lymphoma

The two main types are:

  • Hodgkin’s lymphoma or Hodgkin’s disease, and
  • Non-Hodgkin’s lymphoma

The difference between Hodgkin’s and non-Hodgkin’s lymphoma is the type of lymphocyte involved. If the Reed-Sternberg cell is identified it is classed as Hodgkin’s lymphoma, if not then it is non-Hodgkin’s lymphoma.

Signs and symptoms

There are several signs and symptoms associated with lymphoma. They include:

  • Painless swelling or lymph nodes in your neck, armpits or groin
  • Persistent fatigue
  • Fever
  • Night sweats
  • Shortness of breath
  • Unexplained weight loss
  • Itchy skin

Risk factors

Medical professionals are not sure what causes lymphoma, however there are some factors which may increase the risk.

  • Age - Non-Hodgkin’s lymphoma can happen at any age however it is more common in people 60+. Hodgkin’s lymphoma is more likely diagnosed in people aged in their 20s and 30s, and those over 55.
  • Males are more likely to develop lymphoma than females.
  • Having an impaired immune system.
  • Infections – some infections are linked to an increased risk, for example Epstein-Barr virus and Helicobacter pylori infection.

Lymphoma in women during pregnancy

Lymphoma during pregnancy is rare, however this type of cancer is the most common blood cancer during pregnancy. Hodgkin’s lymphoma (HL) is one of the most common subtypes found during pregnancy, which is mostly due to the peak incidence corresponding to the female reproductive age.

Lymphoma during pregnancy can be a difficult and challenging condition to treat, yet recent studies have shown that treating the condition is possible and chemotherapy can be administered safely during pregnancy.

A research review from 2019 found that lymphoma during pregnancy is a possible curable disease with positive outcomes for both the mother and the foetus. Treatment options are determined by the type and stage of the disease along with gestational age. Pregnant women diagnosed with non-Hodgkin’s lymphoma are shown to be at a higher risk for preeclampsia, caesarean-section, preterm births and post-partum blood transfusions.

Another small study from 2019 comprising of 19 pregnant women diagnosed with Hodgkin’s and non-Hodgkin’s lymphoma, found that starting treatment during pregnancy does not infer a harmful long-term outcome. Two women chose not to proceed with the pregnancy; seventeen women had live births; and eight received antenatal chemotherapy which began at an average gestational age of 23 weeks. During the follow-up period of approximately 32 months, 14 women participated – 13 patients are well and disease free and one had relapsed. Therefore, regular chemotherapy treatments can be administered during the 2nd and 3rd trimester, with negligible maternal or foetal complications.

Rheumatoid arthritis and lymphoma

An investigation into the risk of cancer among patients with rheumatoid arthritis found blood cancers were more frequent among this group. Hodgkin's lymphoma, diffuse large B cell lymphoma and follicular lymphoma were among the haematological cancers found to have an elevated risk. (Risk of cancer for patients with rheumatoid arthritis versus general population).

References

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Author: Gina Rodgers

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