Non-Hodgkin's lymphoma is the most common lymphatic cancer, and it appears in many extra-lymphatic types, and its diagnosis and treatment requires the best and most skilled hands of Turkish doctors.
What is lymphoma?
Cancerous lymphocytes can travel through the blood and lymph system and spread and grow in many parts of the body, including the lymph nodes, spleen, bone marrow and many other organs.
Non-Hodgkin lymphoma: It is the most common, and includes all tumors that do not fall under the classification of Hodgkin lymphoma.
Overview of the lymphatic system and lymphocytes
The lymphatic system is an important part of the immune system in the human body and it rids the body of many toxins and eliminates many pathogens that attack the body.
The lymphatic system consists of the lymph, lymph vessels, lymph nodes, bone marrow, spleen, thymus gland, and amygdala.
Overview of the lymphatic system to facilitate understanding of non-Hodgkin lymphoma
Mature cells express either CD4, in this case, helper T cells, or CD8, called killer or suppressor T cells.
Non-Hodgkin's Lymphoma
How do doctors distinguish Hodgkin's lymphoma from non-Hodgkin's lymphoma?
Types of Non-Hodgkin's Lymphoma
B-cell lymphoma
Diffuse Large B Cell Lymphoma
Follicular lymphoma
Chronic lymphocytic leukemia (CLL/SLL)
Burkitt Lymphoma
- Burkitt Endemic: As we mentioned, it is spread in children and adolescents in Africa and is often associated with infection with the Epstein-Barr virus, and it often affects their jaw and facial bones, and it can also arise in the intestines, kidneys and other organs.
We note in the picture an endemic Burkitt lymphoma that has affected the jaw.
- Sporadic isolated brookite: They are isolated cases that appear in different parts of the world, and here they often arise in the abdomen.
- Immunodeficiency-associated Burkitt: It is associated with acquired immunodeficiency syndrome (AIDS).
It needs immediate and intensive treatment due to its rapid spread and growth, although half of the patients recover after intensive chemotherapy.
We note the characteristic microscopic appearance of Burkitt's lymphoma and the presence of Tingible bodies (white spots).
Mantle Cell Lymphoma
Marginal Zone Lymphoma MZL
- Marginal Outward Nodal Extra-Nodal MZL: the most common, It arises in areas outside the lymph nodes and often in MALT where this type can be called MALT lymphoma, and it is either gastric or extra-infectious, this type appears with a medical history of chronic infection (Pylori,
- Marginal Streptococcus Nodal MZL: They originate in the lymph nodes or bone marrow.
- Splenic MZL: They originate in the spleen, blood, or bone marrow.
Lymphoplasmacytic Non-Hodgkin's Lymphoma
T . non-Hodgkin's lymphoma
T-lymphocytic leukemia
Peripheral T-cell lymphoma
- Anaplastic Large Cell Lymphoma: ALCL can be systemic (occurring all over the body) or cutaneous (limited to the skin). Systemic ALCL is usually at an advanced stage when diagnosed and is fast-growing.
The systemic type is further categorized into two types based on ALK (Anaplastic Lymphoma Kinase) positivity or negativity. Systemic ALCL responds well to treatment, especially ALK-positive disease, but ALK-negative patients may require more aggressive treatments, and relapse occurs more frequently than ALK-positive disease. . - Angioimmunoblastic T-cell lymphoma: It is a rare, severe type that accounts for about seven percent of all patients with T-cell lymphoma in the United States.
Most patients are middle-aged to elderly and are diagnosed at an advanced stage, and there is some evidence that AITL develops from a persistent immune response possibly due to an underlying viral infection (eg Epstein-Barr virus).
Initial symptoms often include fever, night sweats, rash, itching, some autoimmune disorders such as autoimmune hemolytic anemia and immune thrombocytopenia and with elevated levels of gamma globulin in the blood. - Cutaneous T-cell Lymphoma: It is a general term that includes several under slow-growing types, most of which are specific to the skin, and one of these types is Mycosis Fungoides, which is the most common type and is characterized by the presence of papules, plaques, and itchy skin lesions on the course of the body. Another type is Sézary syndrome, which affects the blood and skin and appears as itchy red skin. Severely in most parts of the body, tumor T cells can also be seen, called Sézary cells.
- Lymphoblastic lymphoma: It is rare and arises from lymphoblasts and is more common than T-cell blastocysts.
Causes and risk factors for non-Hodgkin lymphoma
- patient age: The older the patient, the higher the incidence of Non-Hodgkin's lymphoma, as more than a third of cases were diagnosed in the elderly over 75 years.
- Gender: Where there is a slight tendency for infection to occur in males more than in females.
- Sweat: It is believed that whites have a tendency to develop non-Hodgkin lymphoma more than blacks, but this belief needs more detailed studies.
- Previous family story: The incidence of Non-Hodgkin's lymphoma increases when there is an infection among first-degree relatives (brother, father, son...).
- Obesity Recent studies have shown that obese people have an increased risk of some types of Hodgkin lymphoma.
- hereditary autoimmune disease: Such as hypogammaglobulinemia or Wiscott-Aldrich syndrome.
- History of previous exposure to radiation: Such as those who underwent previous radiotherapy or, rarely, survivors of nuclear and chemical disasters.
- Autoimmune diseases: Such as rheumatic fever, Sjögren's disease, systemic lupus erythematosus (SLE) or celiac disease are all conditioned by non-Hodgkin's lymphoma, and AIDS, caused by HIV, can also have a role in this cancer.
- Epstein-Barr virus (EBV) and human T-lymphotrophic virus type I: It has been proven that they have a significant role in the occurrence of genetic mutations in patients with non-Hodgkin lymphoma.
- Chronic infections: Such as infection caused by Helicobacter pylori, hepatitis virus and Chlamydia psittaci.
Symptoms and signs
Lymphoma may not have any symptoms until the tumor has grown to a certain size.
- Profuse night sweats.
- Unexplained weight loss.
- Rash or skin lumps with itchy skin around the whole body.
- Unexplained fever.
- Constant feeling of tiredness and fatigue.
- Increasing the possibility of bleeding such as nosebleeds and heavy menstruation.
- Feeling of breathlessness.
- Feeling full after eating a small amount of food.
- Frequent infections.
Diagnosis of Non-Hodgkin's Lymphoma in Turkey
- Photography of all kinds: Such as ultrasound, CT, positron emission tomography (PET-Scan), simple chest radiograph, and magnetic resonance imaging (MRI).
- Blood tests: Complete blood count (CBC), blood chemical tests, and titration of specific enzymes can be done if a certain type of Non-Hodgkin's lymphoma is suspected.
- Bone Scan.
- biopsy: It is the most important and most accurate diagnostic method, but it is not requested until after other causes and their types are denied bone marrow biopsy.
Interim assessment of non-Hodgkin's lymphoma
The same classification is used in the classification of Hodgkin's Lymphoma and he Lugano classification.
Non-Hodgkin's Lymphoma Treatment in Turkey
It is not always necessary to resort to treatment if non-Hodgkin's lymphoma is diagnosed, as it can be monitored if there are no symptoms or the patient's life is not affected.
Chemotherapy for non-Hodgkin's lymphoma
Chemical drugs target any cell that is constantly dividing in the body, including cancer cells, but as a result, they have many side effects. Cancer cells are not the only ones that regenerate quickly and constantly in the body (hair, skin, blood…).
Treatment is usually given in the form of drug combinations between several drugs to get a better result, and it includes many combinations Chemotherapy For non-Hodgkin's lymphoma, the monoclonal antibody rituximab (Rituxan), usually abbreviated with the letter R and placed at the beginning or end of the acronym, is a combination drug, such as R-CHOP or CHOP-R consisting of cyclophosphamide [cytoxan], doxorubicin [hydroxydonorubicin] , vincristine [oncovin], prednisone.
Intrathecal (into the spinal canal or subarachnoid space) chemotherapy may also be used to treat primary lymphomas that originate in the testicles or sinuses, diffuse large B-cell lymphoma, Burkitt's lymphoma, lymphoblastic lymphoma or some T-cell lymphomas. Aggressive (rapidly growing), given to reduce the spread of lymphoma cells to the brain and spinal cord.
Intrathecal injection of chemotherapy drugs into the spinal canal or subarachnoid space (the Ommaya Reservoir is the area where the cerebrospinal fluid drains).
Immune lymphoma treatment protocol
The field Immunotherapy in Turkey It has expanded significantly in recent times and new generations of drugs and synthetic molecules have appeared to reduce collateral damage, and that Studies Immunotherapy methods are still being developed.
Immunotherapy is based mainly on strengthening the human body's natural immunity or using synthetic antibodies to eliminate deformed cancerous cells at the time of the most common of these methods:
Monoclonal antibodies
They are synthetic proteins that attack cells with certain markers, which greatly reduces side effects, including:
- Antibodies that target the CD20 antigen: CD20 is a protein found on the surface of B cells. These drugs include rituximab (Rituxan), obinutuzumab (Gaziva), ofatumab (Azera) and ibritumumab tuxitan (Zevalin).
- Tet antibody targeting CD30 antigen: It is a protein found on the surface of T cells. An example of this drug is brentuximab vedotin (Adcetris).
- Antibodies that target the CD52 antigen: It is a protein found on the surface of T cells, and a drug that targets this antigen is alemtuzumab.
Chimeric Antigen Receptor (CAR) T cells
This method is considered a breakthrough in the treatment of Non-Hodgkin's Lymphoma and is still Studies List about this method.
Here, T cells are taken from a person's blood and modified in the laboratory to have specific receptors on their surface. These chimeric receptors can attach to proteins on the surface of cancerous lymphoma cells, and this binding enables T cells to destroy tumor cells.
Targeted non-Hodgkin's lymphoma treatment
Non-Hodgkin's Lymphoma Cancer Awareness Month
Hodgkin's and non-Hodgkin's lymphomas can occur in children, adults, and at any age.
Why should I choose treatment in Turkey?
Turkey is distinguished by the presence of the best hospitals equipped with advanced technologies and a medical staff who has successfully performed this type of operation a large number of times.
Recently, Turkey has become one of the leading countries in the field of medical tourism in the world, due to the provision of appropriate treatment with advanced centers and low cost.
Bimaristan Medical Center It is your first choice For treatment in Turkey.
We guide you to the best expert specialists in all departments.
We facilitate the language of communication between you and everyone through specialized Arab doctors who will help you communicate with your doctor.
We help you in securing the appropriate treatment and high-end service in the most modern hospitals and medical centers in Turkey.
We provide our services extensively and precisely.
We accompany you step by step towards recovery.
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don't hesitate toContact usBimaristan, your family center in Turkey.
Frequently asked questions about non-Hodgkin lymphoma cancer treatment in Turkey
Is non-Hodgkin lymphoma serious?
The risk often depends on the type of non-Hodgkin lymphoma (and if it is fast or slow growing), its stage and the age of the patient.
What is the difference between Hodgkin lymphoma and non-Hodgkin lymphoma?
Non-Hodgkin's lymphoma can often be distinguished by tumor localization and spread (in non-Hodgkin's lymphoma it is often outside the lymphatic system in contrast to Hodgkin's lymphoma), but the main differentiating factor is the microscopic arena through the Reed-Sternberg cells characteristic of Hodgkin's lymphoma.
Can Non-Hodgkin's Lymphoma Be Cured?
Recovery depends on the type and stage of the disease, and largely on the age of the patient. Most patients with non-Hodgkin's lymphoma live a normal life after treatment, especially patients with indolent lymphoma.
What is the best treatment for non-Hodgkin's lymphoma?
The current pioneering treatments that are still being worked on are immunotherapy and targeted therapies, as doctors have directed towards these treatments due to their lack of side effects and their ability to treat refractory cancers over other treatments.
What is the cure rate for La Hodgkin's disease?
The complete cure rate for non-Hodgkin's lymphoma depends largely on its type and the stage at which the disease was detected. But in general, the rate of complete recovery exceeds fifty percent.