Follicular lymphoma

Description:

Follicular lymphoma — the monoclonal tumor consisting of mature V-lymphocytes which come from the follicular center of lymph nodes. The follicular lymphoma makes about 1/3 all lymphoid tumors at adults. Average age of the diseased about 60 years, up to 30 years are ill seldom, and incidence at children is presented by isolated cases. A ratio of sick men and women — 1/1,7. Incidence of a follicular lymphoma grows, but less intensively, than, for example, a diffusion V-macrocellular lymphoma.

Angina follicularis symptoms:

The disease debuts increase in one or at once several groups of peripheral lymph nodes (is more often cervical, then axillary and inguinal). Lymph nodes are painless at a palpation, soft. At poll patients quite often note that increase limfouzlovrany was observed; there was a period when they disappeared and then appeared again. As a rule, the fact of repeated increase in lymph nodes or emergence new becomes an occasion of the request for medical care. The majority of sick other complaints to the moment has no address.

Increase in a spleen develops seldom, but its gradual hypertrophy can be followed by passing pains and feeling of weight in left hypochondrium. The general symptoms (perspiration, fever, loss of weight) meet in one of 10 cases, and the main symptoms are caused by local clinical manifestations in the field of finding of the main tumoral masses (often abdominal pains with disorder of function of intestines at massive abdominal lymph nodes). Though the main symptom is increase in lymph nodes, the disease can early extend with a blood flow (gematogenno).

Classification:

More than 60% of patients ask for the help in the IV (widespread) stage of a disease when several groups of lymph nodes are considerably increased and function of bodies is broken. At only 20%bolny state existence of the III stage (damage of chest and belly lymph nodes with the compensated function of bodies). In the I stage (only 1 group of lymph nodes) diagnose no more than 6% of cases and in II (several groups of nodes on the one hand of a diaphragm) — 10%. It is clear, that therapy of subjects is more successful, than earlier the patient got under observation of oncologists.

Morphologically follicular lymphoma is classified by type of the cells making it:

The I follicular type — a tumor on ≥ 75% consists of small cells — follicles;

The II follicular and diffusion type — not less than 25-75% of follicles;

The III diffusion type — less than 25% of follicles.

The tumor morphology exerts impact on an outcome of the disease. It is considered that the I-II types of a lymphoma practically do not recover. The III type, differing in aggression, is more sensitive to treatment. In general, forecast favorable. The statistics speaks about 5-year survival of 70% and 10-year-old — 15%.

Treatment of a follicular lymphoma:

Therapeutic approaches differ depending on a disease stage. The I-II stages of a lymphoma possess more safe forecast irrespective of tumor morphology type. Now the surgical method of treatment (limfadenektomiya) is applied only at primary lymphoma of a GIT.

Use of a beam method proved its high performance in a combination with chemotherapy in the I-II stage as allowed to reduce risk of the side effects caused by radiation of healthy fabrics. At the same time found out that the combined treatment is highly effective at all three types of morphology of a tumor. The combination therapy is usually begun with chemotherapy which without radiation leads to remissions at 70% of patients. However beam treatment is carried surely out in a therapy complex as it gives more expressed local effect.

The combined himioluchevy therapy in the III stage is practically not applied as it does not surpass by results chemotherapy. Radiation of patients in the IV stage of a follicular lymphoma has palliative character. The chemotherapy remains by the leading method of treatment of the III-IV stages. It is begun in the absence of contraindications right after establishment of the diagnosis. At elderly patients with a satisfactory general condition at widespread process use hormonal therapy as an independent method.

Treatment of a follicular lymphoma monoclones is perspective. This influence including direct induction of apoptosis possesses a tumorospetsifichnost and ability to reduce toxicity of chemotherapy. The chemotherapy combination with a bioimmunotherapy monoclones authentically extends remission and life expectancy of patients. In recent years there were several messages from Italy on successful use of anti-virus therapy (interferon) in treatment of a follicular lymphoma.