Lymphoma is a malignant tumor that affects the lymphatic system. In fact, the immune system depends on this system. The vascular system has small organs - lymph nodes, which are distributed throughout the body and reproduce cells. There is also the lymphatic system, which includes the thymus, tonsils, intestines, skin, bone marrow and spleen.
There are two types of lymphocytes: T-lymphocytes (T cells) and B lymphocytes (B cells). The lymphocyte function is to produce antibodies that help immunity to combat pathogenic bacteria. T-lymphocyte function is to recognize and kill tumor and virus-infected cells.
Non-Hodgkin's lymphoma arises when malignant T and B cells are developed due to an error during the production of lymphocytes. These abnormal cells are developing faster than normal, and their life expectancy is longer. Ratio of B-cell lymphomas is 85%, T-cell - 15%. There are 29 types of non-Hodgkin lymphoma (NHL).
Types of lymphoma
Non-aggressive non-Hodgkin's lymphoma:
- Follicular lymphoma – is diagnosed in 20-30% patients, occurs predominantly in middle-aged peoples and adults. Abnormal B-lymphocytes are developed, the pathology is located in several places.
- Chronic lymphocytic leukemia (small lymphocytic lymphoma) - malignancies appear in bone marrow and lymph nodes, the symptoms are similar to follicular type of lymphoma.
- Marginal zone lymphoma - is diagnosed in people over the age of 60 years, it occurs in the lymph nodes and beyond them. In patients suffering from this type of pathology previously are observed problems with immunity.
- Lymphoplasmacytic lymphoma (macroglobulinemia) - a rare type of non-Hodgkin lymphoma develops mostly in late middle age. There is such a symptom, as an increase in the level of protein (IgM).
- Cutaneous T-cell lymphoma - tumor formations occur on the skin, pathology develops between the ages of 50-60 years.
Aggressive non-Hodgkin lymphoma:
- Diffuse large cell lymphoma - a common type of pathology, the average age of the patients is 57 years old. It appears in the lymph nodes, thyroid, in the digestive system, breast, central nervous system, bones and skin.
- Lymphoma of mantle cell - a B-cell lymphoma, occurs more frequently in men over 50 years, one of the most aggressive types of pathology.
- Burkitt's lymphoma - mainly occurs in HIV patients, in men and 90% of the disease occurs at the age of about 30 years.
- Peripheral T-cell lymphoma - little-studied form of lymphoma, characterized by an aggressive character.
Risk factors for non-Hodgkin lymphoma
Risk factors may be related to heredity and way of life:
- Age - in most cases NHL in people is diagnosed in people older than 60 years.
- Being overweight (obesity) - increases the risk of developing pathology.
- Innate immunity disorders increase the risk of NHL in children and young adults.
- Human immunodeficiency virus.
- Epstein-Barr virus in patients with HIV.
- Radiation - radiation therapy, combination of chemotherapy and radiation.
- Herbicides, benzene, insecticides.
- The bacterium Helicobacter pylori, which is cause of stomach ulcers, can cause pathology of the same location.
The symptoms of non-Hodgkin lymphoma
- Swollen lymph nodes (painful or painless).
- Increased body temperature.
- Night sweats.
- Weight loss without reason by more than 10%.
- Fatigue and general weakness.
Stages of non-Hodgkin lymphoma
- Step I: malignant cells localized in separate groups of nodes (e.g., neck)
- Stage II: tumor cells are located on one side of the diaphragm (below or above) in two or more lymph nodes.
- Stage III: located over and under the diaphragm. Furthermore, it can be detected in nearby tissues and organs.
- Stage IV: the tumor has spread outside the bone marrow and lymph nodes, it affects at least one organ.
Diagnosis of non-Hodgkin lymphoma in Israel
In the treatment of lymphoma in Israel, the first step in therapy is diagnostic procedures, according to which the Israeli doctors will put the final diagnosis and pick up an individual treatment protocol. Diagnostic takes 3-5 working days and include the following procedures:
- Blood tests;
- consultation of specialized professionals;
- MRI and PET-CT;
- A biopsy, or revision of biopsy;
- Bone marrow puncture;
Coordination center Isramedic collaborates with the best public and private clinics in Israel, and provides an opportunity to receive treatment by leading doctors. We cooperate with such famous hematologists as:
- Professor Ofer Spielberg – hematologist, specializes in the treatment of cancer pathologies of blood - namely, engaged in therapy of non-Hodgkin lymphoma;
- Professor Elizabeth Naparstek - leading hematologist in Israel, an expert in the treatment of lymphoma, leukemia, and multiple myeloma.
When the type of non-Hodgkin's lymphoma is diagnosed, the doctor prescribes the optimal therapy protocol, taking into account the overall health of the patient.
Treatment of non-Hodgkin lymphoma in Israel
Treatment program depends on the stage of cancer, the variety, the possible presence of comorbidities. As a rule is appointed complex therapy, that involves the use of several treatments.
Non-Hodgkin's lymphoma can be aggressive or non-aggressive, on the basis of this, the specialist selects the optimal treatment program.
Thus, in treatment of non-aggressive tumors are used chemotherapy in combination with immunotherapy, and aggressive non-Hodgkin's lymphoma is treated with chemotherapy and radiotherapy followed by bone marrow transplant.
Chemotherapy and radiotherapy
If non-Hodgkin lymphoma was diagnosed in the early stages of development, the most effective treatment is chemotherapy. Today chemotherapy drugs exert effective influence on the cancer cells, and contribute to slowing down the development of malignancy. Applied in the treatment of non-Hodgkin's lymphoma in Israel CHOP protocols have undergone some changes, and become more efficient. Traditional CHOP scheme involves the use of a combination of cytotoxic drugs - Doxorubicin, Vincristine, Cyclophosphamide and Prednisolone. Sometimes therapy may be supplemented by other drugs. This approach made it possible to increase overall patient survival and reduce the number of disease recurrence.
Many aggressive forms of non-Hodgkin lymphoma are sensitive for high-dose chemotherapy, and this treatment can achieve remission in more than 70% of patients.
Often chemotherapy in Israel is administered in combination with radiation therapy. This approach can increase the effectiveness of treatment and is used for recurrent disease.
Methods of biological therapy are also now actively used in the treatment of non-Hodgkin lymphoma in Israel. They help to "activate" the patient`s immune system to fight the cancer cells. The most effective drug which is based on monoclonal bodies is Rituximab, the effectiveness of which is confirmed by clinical studies.
Often this method of therapy is administered in combination with radiotherapy or chemotherapy. This approach makes it possible to get fairly quick results - namely, to reduce the size of cancerous cells and stop the growth of malignant process, thereby improve the patient's condition.
Bone marrow transplantation
If chemotherapy and other methods of treatment of non-Hodgkin lymphoma did not have the desired effect, the doctor decides to carry out bone marrow transplantation. This may suggests the use of the patient's own cells and stem cells from related or unrelated donors. The cost of a bone marrow transplant in Israel is from 60 thousand to 150 thousand dollars.