What Is Lymphoma?

Why Choose UH Seidman Cancer Center for Lymphoma Treatment?

• UH Seidman Cancer Center has been ranked one of the best cancer hospitals in the country according to U.S. News & World Report for more than 20 years.
• UH Seidman Cancer Center is part of the NCI-designated Case Comprehensive Cancer Center, one of 57 NCI-designated comprehensive cancer centers in the country.
• Our Stem Cell Transplant Program – the oldest in Ohio – has offered advanced bone marrow, cord blood and stem cell transplant services for more than 45 years. Our team has unparalleled expertise in cell therapy, performing over 3,500 stem cell transplants since the program’s inception.
• We were also among the first cancer centers to offer CAR T-cell therapy. We have developed many novel forms of this therapy.
• UH Seidman Cancer Center has a 30-bed inpatient unit specializing in the treatment of lymphoma and other hematologic malignancies.

What Are Lymphocytes?

To understand lymphoma, it is helpful to know what the lymphatic system is and how it works. Lymphocytes, the cells that cause lymphoma, are present in the lymph nodes and within most organs of the body. Lymphocytes circulate throughout the body and play a very important role in defending us from infections.

Different types of lymphoma arise from different types of lymphocytes, including B-cells, T-cells and NK-cells. B-cell lymphoma and T-cell lymphoma are the more common types, while NK-cell lymphoma is rare.

What Causes Lymphoma?

In most cases, lymphoma is sporadic, meaning we don’t know why it happens. However, we know that lymphoma begins when a lymphocyte develops a specific genetic mutation. The mutation causes the cell to multiply rapidly, creating many diseased lymphocytes. Occasionally, patients have an increased risk for lymphoma or related disorders within their family for reasons that are mostly unknown.

Although the underlying cause or causes of lymphoma are poorly understood, certain factors can increase the risk of a person developing lymphoma, including:

• An impaired immune system: An immune system disease or medication that suppresses the immune system can increase the risk of lymphoma.
• Age: Certain types of lymphoma occur more often in young adults, while others are more common in people over 55.
• Certain infections: Although infections rarely cause lymphoma, Helicobacter pylori bacteria infections occasionally cause gastric lymphoma, which is treated with antibiotics. One of the most common human viruses in the world, EBV infects most people in their lifetime, usually without causing illness or symptoms. In rare cases, the Epstein-Barr virus (EBV) can cause lymphoma.
• Environmental: Lymphoma is more common in rural areas, where increased risk is attributed to exposure to insecticides.

Types of Lymphoma

There are many different types of lymphoma that can affect people of all ages. These are categorized into two main types of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma.

Symptoms of Lymphoma

Patients with lymphoma can present with a variety of symptoms. The most common ones are:

• Painless swelling of one or more lymph nodes in the neck, underarms or groin
• Persistent fatigue
• Unexplained fever
• Unexplained weight loss
• Severe night sweats
• Itchy skin
• Easy bruising or bleeding

Many lymphoma symptoms are similar to symptoms caused by a number of other conditions. As such, the presence of these symptoms does not necessarily mean lymphoma is the cause. Conversely, lacking any of these symptoms does not rule out lymphoma.

Diagnosis of Lymphoma

Because many types of lymphoma exist, identifying the type or subtype is essential to developing the optimal treatment plan. UH Seidman Cancer Center utilizes the latest technologies and state-of-the-art equipment to accurately diagnose, stage and treat all types of lymphoma.

Tests and procedures used to diagnose lymphoma include:

• Physical exam: If your doctor suspects the possibility of lymphoma, they will check for swollen lymph nodes and other signs of the disease.
• Lymph node biopsy: In a lymph node biopsy, either a small piece of a lymph node or an entire lymph node is removed to be tested in a lab to see if lymphoma cells are present and to identify the type of lymphoma.
• Bone marrow aspiration and biopsy: Often done following a lymphoma diagnosis to help determine if the disease has reached the bone marrow, these procedures involve inserting a needle into the hipbone to extract a bone marrow sample for testing at a lab.
• Imaging tests: Imaging tests such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) may be ordered to look for evidence of lymphoma in the body.
• Blood tests: Your doctor will order blood tests to assess the lymphoma and its effects on your body.

Lymphoma Treatment

At UH Seidman Cancer Center, we develop personalized care plans for each patient with a team that includes hematologists, pathologists and radiation oncologists. Additional expertise is called on for patients whose lymphoma affects certain organs. For example, patients with skin lymphoma will see a dermatologist, while patients whose lymphoma involves their stomach or intestines will see a gastroenterologist. Surgery (through biopsy) is often necessary for establishing diagnosis but is rarely part of treatment.

The treatment and prognosis of lymphoma continues to improve, thanks to new drug development. Treatment plans may include:

• Chemotherapy continues to be widely used, with newer chemotherapy drugs having fewer side-effects and being well tolerated.
• Targeted agents are newer medications that hone in on lymphoma cells while causing minimal side effects to healthy organs.
• Radiation therapy is one of the oldest treatments for lymphoma. It is highly effective and necessary for some forms of lymphoma. A special form of radiation called proton therapy is particularly effective in treating lymphoma in children.
• CAR T-cell therapy is a form of therapy in which the patient’s own immune system cells are harnessed and altered in a lab so that they attach to and kill lymphoma cells.
• Bispecific T-cell engagers (BiTEs) are novel drugs that target lymphoma cells and are extremely effective at engaging the patient’s own immune system.
• Stem cell transplant is the most intensive form of treatment and may be used when other treatments fail.
• Supportive Care and Survivorship: During and after successful treatment, many health issues continue to require monitoring.
• Clinical Trials: The treatment of lymphoma has improved through clinical trials. We invite you to participate.