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Non-Hodgkin’s Lymphoma

Dr. Tjatur Winarsanto SpPD RST Ciremai 2011

Lymphoma        History and Overview Statistics What it effects (biology) Classification and Staging Symptoms Causes and Risk Factors Diagnosis and Treatment .

Lymphoma’s Where They Begin  Lymphomas are a cancer of the lymphatic system • Lymphatic vessels • Lymph nodes (underarms. neck. groin. tonsils and bone marrow) . spleen.

Lymphatic System American Medical Association .

370 new cases 19.550 new cases and a Death rate of 1.410 deaths for 2004 • In California Alone there are est. .730 (California has the highest incidence and Death rate for NonHodgkin’s Lymphoma • Non-Hodgkin’s Lymphoma is the 6th and 7th most deadly cancers for men and women • Recent studies have shown that overweight patients are more likely to die then those patients who are in better shape. 5.Non-Hodgkin’s Lymphoma Statistics   54.

Classification  Usually classified by how the cells look under a microscope and how quickly they grow and spread • Aggressive lymphomas (high-grade lymphomas) • Indolent Lymphomas (low-grade lymphomas) .

Each stage is then divided into categories A. night sweats and weight loss • E: Spreading of disease from lymph node to another organ . B.Non-Hodgkin’s Lymphoma Staging   Stage is the term used to describe the extent of tumor that has spread through the body( I and II are localized where as III and IV are advanced. and E • A: No systemic symptoms • B: Systemic Symptoms such as fever.

Staging .

Non-Hodgkin’s Lymphoma  Two main types of Non-Hodgkin’s Lymphoma:  B-Cell and T-Cell Lymphomas • B-Cell lymphomas (80%) • T-Cell lymphomas (15%) .

B-Cell Lymphoma (80%)    B-Cells help make antibodies. which are proteins that attach to and help destroy antigens Lymphomas are caused when a mutation arises during the B-cell life cycle Various different lymphomas can occur during several different stages of the cycle • Follicular lymphoma. . which is a type of B-cell lymphoma is caused by a gene translocation which results in an over expressed gene called BCL-2. which blocks apoptosis.

B-Cell Cancers .

T-Cell Lymphoma (15%)   The T-cells are born from stem . They help the immune system work in a coordinated fashion. • These types of lymphomas are categorized by how the cell is affected  Anaplastic Large cell Lymphoma. but mature in the thymus. similar to that of B-cells. t-cell lymphoma caused by a gene translocation in chromosome 5 Lymphoma.

Symptoms       Painful Swelling of lymph nodes located in the neck. underarm and groin. Unexplained Fever Night Sweats Constant Fatigue Unexplained Weight loss Itchy Skin Cancer Sourcebook .

org .Causes and Risk Factors  The Exact causes are still unknown • Higher risk for individuals who:     Exposed to chemicals such as pesticides or solvents Infected w/ Epstein-Barr Virus Family history of NHL (although no hereditary pattern has been established) Infected w/ Human Immunodeficiency Virus (HIV) Lymphoma.

Diagnosis      X-Rays CT scans Magnetic Resonance Imaging (MRI) Biopsy Lymphangiogram • Pictures of the lymphatic system taken w/ x-ray after a special dye is injected to illuminate lymph nodes and vessels .

known as “watchful waiting”  .Treatment  Non-Hodgkin’s Lymphoma is usually treated by a team of physicians including hematologists. medical oncologists and a radiation oncologist. the Doctor may wait to start treatment until the patient starts showing symptoms. In some cases such as for Indolent lymphomas.

.Treatment Options       Chemotherapy Radiation Bone Marrow Transplantation Surgery Bortezomib (Velcade) Immunotherapy  Using the bodies own immune system combined with material made in a lab.

Survival Rates  Survival Rates vary widely by cell type and staging. • 1 Year Survival Rate: 77% • 5 Year Survival Rate: 56% • 10 Year Survival Rate: 42% .

Any Questions? .