Understanding Non-Hodgkin Lymphoma

By PAUL JACOBS, M.D. What Is Non-Hodgkin Lymphoma? Lymphoma refers to a malignancy of the lymphatic system. The lymphatic system is a network of nodes (knots of tissue) connected by vessels. Together, the lymph nodes drain fluid and waste products from the body. The lymph nodes act as tiny filters, removing foreign organisms and cells. Lymphocytes, are a type of white blood cell that helps fight infections caused by bacteria, viruses, or fungi. The lymph node function is to prevent infections from entering the bloodstream. When the lymphatic system is fighting an active infection, you may notice that some of the lymph nodes in the area of the infection become swollen and tender. This is the bodys normal reaction to an infection. Lymphoma occurs when the lymph-node cells or the lymphocytes begin to multiply uncontrollably, producing malignant cells that have the abnormal capacity to invade other tissues throughout your body. The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma. The differences in these two types of lymphoma are certain unique characteristics of the different lymphoma cells. Non-Hodgkin lymphoma is further classified into a variety of subtypes based on the cell of origin (Bcell or T-cell), and the cell characteristics. The subtype of Non-Hodgkin lymphoma predicts the necessity of early treatment, the response to treatment, the type of treatment required, and the prognosis. Non-Hodgkin lymphoma is much more common than Hodgkin lymphoma. Non-Hodgkin lymphoma is the fifth most common cause of cancer-related deaths in the United States. The risk of developing nonHodgkin lymphoma increases with age. Non-Hodgkin lymphoma is more common in males than in females and in Caucasians. The incidence of non-Hodgkin lymphoma is increasing with the passage of time. The United States has the highest incidence of non-Hodgkin lymphoma. What Causes Non-Hodgkin Lymphoma? The exact cause of non-Hodgkin lymphoma is unknown. However, there are multiple medical conditions that are associated with an increased risk of developing non-Hodgkin lymphoma: Inherited immune deficiencies: ataxia-telangectasia, Wiskott-Aldrich syndrome, common variable immunodeficiency, severe combined immunodeficiency, and X-linked lymphoproliferative syndrome Genetic syndromes: Down syndrome, Klinefelter's syndrome (a genetic condition in men caused by an extra X chromosome) Immune disorders, and their treatments: Sjgren's syndrome (an immune disorder characterized by unusual dryness of mucus membranes), rheumatoid arthritis, systemic lupus erythematosus Celiac disease, a disease involving the processing of certain components of gluten, a protein in grains Inflammatory bowel disease, particularly Crohns disease, and its treatment Psoriasis Family history of lymphoma Bacteria: Helicobacter pylori, asssociated with gastritis and gastric ulcers; Borrelia burgdorferi, associated with Lyme disease; Campylobacter jejuni; Chalmydia psittaci Viruses: HIV, HTLV-1, SV-40, HHV-8, Epstein Barr virus, hepatitis virus

Non-random chromosomal translocations and molecular rearrangements Symptoms of non-Hodgkin's lymphoma (NHL) depend on the area of the body affected by the disease. The most common symptom is a painless swelling of the lymph nodes in the neck, underarm, or groin. Other symptoms may include: Unexplained fever. Night sweats. Extreme fatigue. Unexplained weight loss. Itchy skin. Reddened patches on the skin. A cough or shortness of breath. Pain in the abdomen or back.

Title: Understanding Non-Hodgkin Lymphoma Reference: http://www.fccc.edu ; by Paul Jacobs, M.D.

Summary: Non-Hodgkin lymphoma is further classified into a variety of subtypes based on the cell of origin (Bcell or T-cell), and the cell characteristics. The subtype of Non-Hodgkin lymphoma predicts the necessity of early treatment, the response to treatment, the type of treatment required, and the prognosis. Non-Hodgkin lymphoma is much more common than Hodgkin lymphoma. Non-Hodgkin lymphoma is the fifth most common cause of cancer-related deaths in the United States. The risk of developing nonHodgkin lymphoma increases with age. Non-Hodgkin lymphoma is more common in males than in females and in Caucasians. The incidence of non-Hodgkin lymphoma is increasing with the passage of time. The United States has the highest incidence of non-Hodgkin lymphoma. The exact cause of non-Hodgkin lymphoma is unknown. However, there are multiple medical conditions that are associated with an increased risk of developing non-Hodgkin lymphoma: Inherited immune deficiencies; Genetic syndromes; Immune disorders, and their treatments; Celiac disease; Inflammatory bowel disease, particularly Crohns disease, and its treatment; Psoriasis; Family history of lymphoma; Bacteria; Viruses and Non-random chromosomal translocations and molecular rearrangements. Symptoms of non-Hodgkin's lymphoma (NHL) depend on the area of the body affected by the disease. The most common symptom is a painless swelling of the lymph nodes in the neck, underarm, or groin. Other symptoms may include: Unexplained fever; Night sweats; Extreme fatigue; Unexplained weight loss; Itchy skin; Reddened patches on the skin; A cough or shortness of breath; Pain in the abdomen or back. Reaction: After reading the entire article, it made me realize certain important points that I should remember about Non-Hodgkin's Lymphoma; first is its causes, then second is its symptoms. It is very important to know these important facts about NHL because as what had been mentioned in the article, fifth most common cause of cancer-related deaths in the United States, not only in the US but also in the Philippines, more and more cases are reported for NHL. As of my own experience, my grand father died at the age of 84 due to Non- hodgkin's lymphoma. Although we thought that nothing was wrong with him because he was still so strong and healthy at that age, still we were all wrong. Slowly as years passed by, my grand mother noticed some growing nodules on his neck, armpits and underarm but she just ignored them because we thought that they were just lusay, as what we call swollen lymph nodes. What we just noticed abnormally to him was his constant sleeping. He couldn't control his sleeping habits, he was always tired and would always say that his body was very weak. What we thought as normal symptoms of aging turned out to be Non- Hodgkin's Lymphoma. Our family truly regretted that we had not detected it earlier. Knowing the causes and symptoms of Non- hodgkin's lymphoma, I am now very aware and welleducated of the basics of the disease so whenever a member of our family would portray the same symptoms manifested by my grand father, I would be the first one to recommend seeking medical attention. Not only that it made me aware, knowing these facts would also help me in handling more future patients with the same diagnosis. The article was very helpful for me to render the right and appropriate nursing care given to a patient suffering from such disease.