Lymphoma

Description:

Lymphoma - group of the hematologic diseases of lymphatic fabric which are characterized by a hyperadenosis and/or damage of various internals in which there is an uncontrolled accumulation of "tumoral" lymphocytes. The first symptoms of lymphoma - an angiomegaly of different groups (cervical, axillary or inguinal).

Existence of primary tumoral center, like solid tumors is characteristic of lymphoma. However lymphoma are capable not only to innidiation (as solid tumors), but also to dissimination on all organism along with formation of the state reminding a lymphoid leukosis.

Allocate Hodzhkin's (lymphogranulomatosis) lymphoma and nekhodzhkinsky lymphoma (English Non-Hodgkinlymphoma).

Lymphoma symptoms:

As a rule, the first symptom of a lymphoma is significant increase in the sizes of lymph nodes on a neck, in axillary hollows or in a groin. At the same time, unlike infectious diseases, the increased lymph nodes are painless, their sizes do not decrease with time and at treatment by antibiotics. Sometimes, owing to pressure from increased a liver, a spleen and lymph nodes, there is a feeling of overflow in a stomach, the breath difficulties which are holding apart lower back pains, feeling of pressure in the person or on a neck

Other symptoms which are found at a lymphoma are:

    * Weakness
    * Fervescence
    * Perspiration
    * Loss of weight
    * Digestion disturbances

Types of lymphoma

The term nekhodzhkinsky lymphoma designate quite big group of lymphoma which are not Hodzhkin's disease (lymphogranulomatosis). The decision on lymphoma belonging to group of nekhodzhkinsky lymphoma or to Hodzhkin's disease is accepted after the histologic research of a sample of biopsirovanny fabric. If at microscopic examination find Berezovsky-Shternberg-Read's cells, specific to Hodzhkin's disease, then make the diagnosis to Hodzhkin's disease. If these specific cells do not find, then carry a lymphoma to group of nekhodzhkinsky.

Nekhodzhkinsky lymphoma have many subspecies which differ on a histologic picture, clinical manifestations and approaches to their treatment. One types of lymphoma have a slow and favorable current, sometimes a long time do not demand special treatment. Such lymphoma call indolentny. Some other lymphoma, on the contrary, are characterized by bystry progressing, a large number of symptoms and demand an immediate initiation of treatment. Such lymphoma call aggressive. Lymphoma meet intermediate characteristics. Most often the abnormal growth of lymphocytes begins in lymph nodes, at the same time the classical option of a lymphoma which is followed by a hyperadenosis develops. However lymphoma at which lymph nodes do not increase since the disease initially arises not in a lymph node, and in various bodies meet: spleen, stomach, gut, lungs, brain. Such lymphoma call extranodal.

Long time in many countries there were various classifications including different names and terms for designation of the same type of nekhodzhkinsky lymphoma that created great difficulties, both for doctors, and for patients. In 2001 the international community developed uniform approaches to classification of lymphoma, and uniform, so-called classification of the World Health Organization (WHO) which use in the majority of the countries of the world today was accepted.

We submit the WHO classification in full. At desire everyone can get acquainted with it so as far as he considers for himself necessary.

Lymphoma stages

Definition of a stage of a lymphoma helps to understand degree of prevalence of a disease. It is important information for adoption of the correct decision concerning the program of treatment. Approaches to treatment of initial (local) stages and widespread stages of lymphoma usually differ. When electing the program of treatment consider not only a stage, but also many other factors: a type of a lymphoma, results of additional researches (cytogenetic, immunological, molecular other), the condition of the patient, his age accompanying a disease, etc. Nevertheless, information on a stage of a disease is extremely important for development of the effective program of treatment.

According to the standard international classification (it is called classification Ann Arbor according to the name of the city in the USA where it was accepted) allocate 4 stages of a disease: The I, II, III and IV. Usually add a letter A to number of a stage or B. By means of these letters point to existence or lack of 3 important symptoms which can occur at patients with a lymphoma: the fever expressed to night perspiration and weight reduction. If use a letter A - it means that the above-stated symptoms are absent if use a letter B - it speaks about existence at the patient of the above-stated symptoms.

In classification four stages of a disease which can be conditionally designated as local (local, limited) - the I and II stages and extended - III and IV a stage are allocated.

    * The I stage - is allowed involvement in limfomny process of one area of lymph nodes
    * The II stage - is allowed involvement in process of two and more areas of lymph nodes on the one hand of a diaphragm (the diaphragm is a muscular leaf which divides a thorax and an abdominal cavity).
    * The III stage - is allowed damage of lymph nodes on both sides of a diaphragm.
    * The IV stage - a disease extends in addition to lymph nodes to internals: heart, liver, kidneys, gut, marrow, etc.

Lymphoma reasons:

The etiology of lymphoma remains to the unknown. Among etiological factors such, the general traditionally are considered for all neoplastic diseases, factors as the ionizing radiation, chemical carcinogens, unfavorable conditions of the environment. In addition it is necessary to stop for roles of viruses as in some cases development of lymphoma the expressed interrelation between influence of a virus and tumoral growth is traced. It was so shown that at children of patients with a local African lymphoma of Berkitt in 95% of cases infection with a virus Epstein - Barrel takes place.

Treatment of the Lymphoma:

The choice of the program of treatment depends on a type of a lymphoma and a condition of the patient.

    * Indolentny lymphoma in some cases can not demand treatments, observation of the doctor (the hematologist or the oncologist) is sufficient. However emergence of the first signs of progressing of a disease: a hyperadenosis, strengthenings of weakness, fervescence, etc. is a signal to start treatment. At locally widespread stages often use radiotheraphy - radiation of the lymph nodes affected with a tumor. At generalized stages preference is given to chemotherapy. The range of possible drugs for treatment of indolentny lymphoma is rather big: Chlorbutinum, флударабин, Cyclophosphanum, Vincristinum, ритуксимаб, etc. Indolentny lymphoma belong to diseases which full treatment is represented improbable today. A main objective of treatment of indolentny lymphoma consider increase in duration and improvement of quality of life of the patient.
    * Aggressive lymphoma, as a rule, demand an immediate initiation of treatment. One of the most widespread programs of chemotherapy is the CHOP program in combination with use of a monoclone Rituksimab.
    * Highly aggressive lymphoma are treated according to programs of chemotherapy for acute lymphoblastoid leukoses or similar to them. The purpose of treatment of aggressive and high-aggressive lymphoma is treatment. However, it is possible not in all cases.
    * One of effective programs of treatment of aggressive and high-aggressive lymphoma is the high-dose chemotherapy with transplantation of the hemopoietic stem cells.

The choice of a method of treatment is a stage of adoption of very important decision which has to be based on the exact data concerning the diagnosis of a disease taking into account specific features of the patient. Discussion of questions of treatment with the patient and, at his desire, with his relatives is the integral element of the approval of the general program of treatment.