Abnormal proliferation of B- or T-lymphocytes is a pathology seen with multiple histological subtypes, each of which can present a very variable clinical course. These lymphomas can be high grade (aggressive but potentially curable) or low grade (more indolent but still incurable with chemotherapy).
The incidence of lymphomas has been increasing worldwide, and there is a geographic variation in the prevalence of subtypes of lymphomas around the world.
The symptoms of lymphomas can range from asymptomatic to early-stage disease and ‘B’ symptoms (e.g. anaemia, haemorrhage, infection).
Bloods: A full blood count may reveal a normochromic normocytic anaemia, thrombocytosis, lymphocytopenia, raised ESR (erythrocyte sedimentation rate) and ALP (alkaline phosphatase).
Imaging: CT Chest, abdomen and Pelvis for staging using the Ann Arbor System.
Bone Marrow Aspirate is used for staging using the Ann Arbor System.
Conservative: In early-stage, low grade disease, a ‘watch and wait’ approach may be taken.
Medical: Treatment options may include antibiotics, chemotherapy, monoclonal antibodies (which recognise lymphoma surface structures, such as CD20 on B lymphocytes, and destroy those cells only), radiotherapy and autologous or allogeneic stem cell transplants for relapsed disease.
Complications of treatment may be life-threatening, with examples including sepsis and organ failure.
The overall survival rate for Stage 1 is approximately 80%.
A = Absence of systemic symptoms
B = Presence of systemic symptoms
