Non-Hodgkin lymphoma - Wikipedia

Non-Hodgkin lymphoma (NHL), also known as non-Hodgkin's lymphoma, is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas. Non-Hodgkinlymphoma FromWikipedia,thefreeencyclopedia Jumptonavigation Jumptosearch Typeofcanceroflymphnodes MedicalconditionNon-HodgkinlymphomaOthernamesNon-HodgkindiseaseMicrographofmantlecelllymphoma,atypeofnon-Hodgkinlymphoma.Terminalileum.H&Estain.SpecialtyHematologyandoncologySymptomsEnlargedlymphnodes,fever,nightsweats,weightloss,tiredness,itching[1]Usualonset65–75yearsold[2]RiskfactorsPoorimmunefunction,autoimmunediseases,Helicobacterpyloriinfection,hepatitisC,obesity,Epstein-Barrvirusinfection[1][3]DiagnosticmethodBonemarroworlymphnodebiopsy[1]TreatmentChemotherapy,radiation,immunotherapy,targetedtherapy,stemcelltransplantation,surgery,watchfulwaiting[1]PrognosisFive-yearsurvivalrate71%(USA)[2]Frequency4.3million(affectedduring2015)[4]Deaths231,400(2015)[5] Non-Hodgkinlymphoma(NHL),alsoknownasnon-Hodgkin'slymphoma,isagroupofbloodcancersthatincludesalltypesoflymphomasexceptHodgkinlymphomas.[1]Symptomsincludeenlargedlymphnodes,fever,nightsweats,weightloss,andtiredness.[1]Othersymptomsmayincludebonepain,chestpain,oritchiness.[1]Someformsareslow-growingwhileothersarefast-growing.[1] Lymphomasaretypesofcancerthatdevelopfromlymphocytes,atypeofwhitebloodcell.[2]Riskfactorsincludepoorimmunefunction,autoimmunediseases,Helicobacterpyloriinfection,hepatitisC,obesity,andEpstein–Barrvirusinfection.[1][3]TheWorldHealthOrganizationclassifieslymphomasintofivemajorgroups,includingoneforHodgkinlymphoma.[6]WithinthefourgroupsforNHLareover60specifictypesoflymphoma.[7][8]Diagnosisisbyexaminationofabonemarroworlymphnodebiopsy.[1]Medicalimagingisdonetohelpwithcancerstaging.[1] Treatmentdependsonwhetherthelymphomaisslow-orfast-growingandifitisinoneareaormanyareas.[1]Treatmentsmayincludechemotherapy,radiation,immunotherapy,targetedtherapy,stem-celltransplantation,surgery,orwatchfulwaiting.[1]Ifthebloodbecomesoverlythickduetohighnumbersofantibodies,plasmapheresismaybeused.[1]Radiationandsomechemotherapy,however,increasetheriskofothercancers,heartdisease,ornerveproblemsoverthesubsequentdecades.[1] In2015,about4.3millionpeoplehadnon-Hodgkinlymphoma,and231,400(5.4%)died.[4][5]IntheUnitedStates,2.1%ofpeopleareaffectedatsomepointintheirlife.[2]Themostcommonageofdiagnosisisbetween65and75yearsold.[2]Thefive-yearsurvivalrateintheUnitedStatesis71%.[2] Contents 1Signsandsymptoms 2Causes 2.1Familialcomponent 2.2HIV/AIDS 3Treatment 3.1Chemotherapy 3.2Treatmentcomplications 3.3Other 4Prognosis 5Epidemiology 5.1Australia 5.2Canada 5.3UnitedKingdom 5.4UnitedStates 6History 7References 8Externallinks Signsandsymptoms[edit] Thesignsandsymptomsofnon-Hodgkinlymphomavarydependinguponitslocationwithinthebody.Symptomsincludeenlargedlymphnodes,fever,nightsweats,weightloss,andtiredness.Othersymptomsmayincludebonepain,chestpain,oritchiness.Someformsareslowgrowing,whileothersarefastgrowing.[1]Enlargedlymphnodesmaycauselumpstobefeltundertheskinwhentheyareclosetothesurfaceofthebody.Lymphomasintheskinmayalsoresultinlumps,whicharecommonlyitchy,red,orpurple.Lymphomasinthebraincancauseweakness,seizures,problemswiththinking,andpersonalitychanges.[9] Whileanassociationbetweennon-Hodgkinlymphomaandendometriosishasbeendescribed,[10]theseassociationsaretentative.[11] Causes[edit] Themanydifferentformsoflymphomaprobablyhavedifferentcauses.ThesepossiblecausesandassociationswithatleastsomeformsofNHLinclude: Infectiousagents: Epstein–Barrvirus:associatedwithBurkitt'slymphoma,folliculardendriticcellsarcoma,extranodalNK-T-celllymphomaanddiffuselargeB-celllymphoma.[12] HumanT-cellleukemiavirus:associatedwithadultT-celllymphoma. Helicobacterpylori:associatedwithgastriclymphoma. HHV-8:associatedwithprimaryeffusionlymphoma,multicentricCastlemandisease. HepatitisCvirus:associatedwithsplenicmarginalzonelymphoma,lymphoplasmacyticlymphomaanddiffuselargeB-celllymphoma.[13] HIVinfection.[14] Somechemicals,likepolychlorinatedbiphenyls(PCBs),[15][16][17]diphenylhydantoin,dioxin,andphenoxyherbicides. Medicaltreatments,likeradiationtherapyandchemotherapy.[citationneeded] Geneticdiseases,likeKlinefeltersyndrome,Chédiak–Higashisyndrome,ataxia–telangiectasiasyndrome.[citationneeded] Autoimmunediseases,likeSjögrensyndrome,celiacdisease,rheumatoidarthritis,andsystemiclupuserythematosus.[18][19] BonetraumaandmicrofracturesassociatedwithdiffuselargeB-celllymphomaoriginatinginbonemarrow.[20][21] Implants,madefromhardmetalsorsilicone,associatedwithanaplasticlargecelllymphoma.[22][23] Familialcomponent[edit] Familiallymphoidcancerisrare.Thefamilialriskoflymphomaiselevatedformultiplelymphomasubtypes,suggestingasharedgeneticcause.However,afamilyhistoryofaspecificsubtypeismoststronglyassociatedwithriskforthatsubtype,indicatingthatthesegeneticfactorsaresubtype-specific.Genome-wideassociationstudieshavesuccessfullyidentified67single-nucleotidepolymorphismsfrom41loci,mostofwhicharesubtypespecific.[24] HIV/AIDS[edit] TheCentersforDiseaseControlandPrevention(CDC)includedcertaintypesofnon-HodgkinlymphomaasAIDS-definingcancersin1987.[25]ImmunesuppressionratherthanHIVitselfisimplicatedinthepathogenesisofthismalignancy,withaclearcorrelationbetweenthedegreeofimmunesuppressionandtheriskofdevelopingNHL.Additionally,otherretroviruses,suchasHTLV,maybespreadbythesamemechanismsthatspreadHIV,leadingtoanincreasedrateofco-infection.[26]ThenaturalhistoryofHIVinfectionhasgreatlychangedovertime.Asaconsequence,ratesofnon-Hodgkinlymphoma(NHL)inpeopleinfectedwithHIVhassignificantlydeclinedinrecentyears.[14] Treatment[edit] ThetraditionaltreatmentofNHLincludeschemotherapy,radiotherapy,andstem-celltransplants.[27][28]TherehavealsobeendevelopmentsinimmunotherapyusedinthetreatmentofNHL.[29] Chemotherapy[edit] ThemostcommonchemotherapyusedforB-cellnon-HodgkinlymphomaisR-CHOP,whichisaregimenoffourdrugs(cyclophosphamide,doxorubicin,vincristine,andprednisone)plusrituximab.[30] Treatmentcomplications[edit] Ifparticipantsreceivestem-celltransplants,theycandevelopagraft-versus-hostdisease.Whencomparedwithplacebofortreatingimmunemediatedinflammationposttransplantationandinautoimmunity,mesenchymalstromalcells(MSCs)mayreducetheall-causemortalityiftheyareusedforatherapeuticreason.[31]Moreover,thetherapeuticuseofMSCsmayincreasethecompleteresponseofacuteandchronicGvHD,buttheevidenceisveryuncertain.[31]TheevidencesuggeststhatMSCsforprophylacticreasonresultinlittletonodifferenceintheall-causemortality,intherelapseofmalignantdiseases,andintheincidenceofacuteGvHD.[31]TheevidencesuggeststhatMSCsforprophylacticreasonreducetheincidenceofchronicGvHD.[31] Platelettransfusionsmaybenecessaryforthosewhoreceivechemotherapyorundergoastemcelltransplantationduetothehigherriskforbleeding.Whencomparingtherapeutic/non-prophylacticplatelettransfusionstoprophylacticplatelettransfusionsthereislittletonodifferenceinthemortalitysecondarytobleedingandtheymayresultinaslightreductioninthenumberofdaysonwhichasignificantbleedingeventoccurred.[32]Theevidencesuggeststhattherapeuticplatelettransfusionsresultinalargeincreaseinthenumberofpeoplewithatleastonesignificantbleedingeventandtheylikelyresultinalargereductioninthenumberofplatelettransfusions.[32][33] Other[edit] Itisunclearifincludingaerobicphysicalexercise,inadditiontothestandardtreatmentforadultpatientswithhaematologicalmalignancies,iseffectiveatreducinganxietyandseriousadverseeffects.[34]Aerobicphysicalexercisesmayresultinlittletonodifferenceinthemortality,inthequalityoflifeandinthephysicalfunctioning.[34]Theseexercisesmayresultinaslightreductionindepressionandmostlikelyreducefatigue.[34] Prognosis[edit] Prognosisdependsonthesubtype,thestaging,aperson'sage,andotherfactors.Acrossallsubtypes,5-yearsurvivalforNHLis71%,rangingfrom81%forStage1diseaseto61%forStage4disease.[35] Epidemiology[edit] Globally,asof2010,therewere210,000deaths,upfrom143,000in1990.[36] Ratesofnon-Hodgkinlymphomaincreasesteadilywithage.[18]Upto45yearsNHLismorecommonamongmalesthanfemales.[37] Australia[edit] Withover6,000peoplebeingdiagnosedyearly,NHListhefifthmostcommoncancerinAustralia.[38] Canada[edit] InCanadaNHListhefifthmostcommoncancerinmalesandsixthmostcommoncancerinfemales.Thelifetimeprobabilityofdevelopingalymphoidcanceris1in44formales,and1in51forfemales.[39] UnitedKingdom[edit] Onaverage,accordingtodataforthe2014–2016period,around13,900peoplearediagnosedwithNHLyearly.ItisthesixthmostcommoncancerintheUK,andistheeleventhmostcommoncauseofcancerdeathaccountingforaround4,900deathsperyear.[40] UnitedStates[edit] Ageadjusteddatafrom2012to2016showsabout19.6casesofNHLper100,000adultsperyear,5.6deathsper100,000adultsperyear,andaround694,704peoplelivingwithnon-Hodgkinlymphoma.About2.2percentofmenandwomenwillbediagnosedwithNHLatsomepointduringtheirlifetime.[41] TheAmericanCancerSocietylistsnon-HodgkinlymphomaasoneofthemostcommoncancersintheUnitedStates,accountingforabout4%ofallcancers.[42] History[edit] WhileconsensuswasrapidlyreachedontheclassificationofHodgkinlymphoma,thereremainedalargegroupofverydifferentdiseasesrequiringfurtherclassification.TheRappaportclassification,proposedbyHenryRappaportin1956and1966,becamethefirstwidelyacceptedclassificationoflymphomasotherthanHodgkin.Followingitspublicationin1982,theWorkingFormulationbecamethestandardclassificationforthisgroupofdiseases.Itintroducedthetermnon-HodgkinlymphomaorNHLanddefinedthreegradesoflymphoma.[citationneeded] NHLconsistsofmanydifferentconditionsthathavelittleincommonwitheachother.Theyaregroupedbytheiraggressiveness.Lessaggressivenon-Hodgkinlymphomasarecompatiblewithalongsurvivalwhilemoreaggressivenon-Hodgkinlymphomascanberapidlyfatalwithouttreatment.Withoutfurthernarrowing,thelabelisoflimitedusefulnessforpeopleordoctors.Thesubtypesoflymphomaarelistedthere.[citationneeded] NeverthelesstheWorkingFormulationandtheNHLcategorycontinuetobeusedbymany.Tothisday,lymphomastatisticsarecompiledasHodgkin'sversusnon-Hodgkinlymphomasbymajorcanceragencies,includingtheUSNationalCancerInstituteinitsSEERprogram,theCanadianCancerSocietyandtheIARC.[citationneeded] References[edit] ^abcdefghijklmnop"AdultNon-HodgkinLymphomaTreatment(PDQ®)–PatientVersion".NCI.3August2016.Archivedfromtheoriginalon16August2016.Retrieved13August2016. ^abcdef"SEERStatFactSheets:Non-HodgkinLymphoma".NCI.April2016.Archivedfromtheoriginalon6July2014.Retrieved13August2016. 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Externallinks[edit] Non-HodgkinLymphomaatAmericanCancerSociety Non-HodgkinsLymphomafromCancer.net(AmericanSocietyofClinicalOncology) ClassificationDICD-10:C82-C85ICD-9-CM:200,202ICD-O:9591/3OMIM:605027MeSH:D008228DiseasesDB:9065ExternalresourcesMedlinePlus:000581eMedicine:med/1363ped/1343PatientUK:Non-HodgkinlymphomaNCI:Non-Hodgkinlymphoma vteLeukaemias,lymphomasandrelateddiseaseBcell(lymphoma,leukemia)(mostCD19 CD20)Bydevelopment/markerTdT+ ALL(PrecursorBacutelymphoblasticleukemia/lymphoma) CD5+ naiveBcell(CLL/SLL) mantlezone(Mantlecell) CD22+ Prolymphocytic CD11c+(Hairycellleukemia) CD79a+ germinalcenter/follicularBcell(Follicular Burkitt's GCBDLBCL Primarycutaneousfolliclecenterlymphoma) marginalzone/marginalzoneB-cell(Splenicmarginalzone MALT Nodalmarginalzone Primarycutaneousmarginalzonelymphoma) RS(CD15+,CD30+) ClassicHodgkinlymphoma(Nodularsclerosis) CD20+(NodularlymphocytepredominantHodgkinlymphoma) PCDs/PP(CD38+/CD138+) seeimmunoproliferativeimmunoglobulindisorders Byinfection KSHV(Primaryeffusion) EBV Lymphomatoidgranulomatosis Post-transplantlymphoproliferativedisorder ClassicHodgkinlymphoma Burkitt'slymphoma HCV Splenicmarginalzonelymphoma HIV(AIDS-relatedlymphoma) Helicobacterpylori(MALTlymphoma) Cutaneous DiffuselargeB-celllymphoma IntravascularlargeB-celllymphoma Primarycutaneousmarginalzonelymphoma Primarycutaneousimmunocytoma Plasmacytoma Plasmacytosis Primarycutaneousfolliclecenterlymphoma T/NKTcell(lymphoma,leukemia)(mostCD3 CD4 CD8)Bydevelopment/marker TdT+:ALL(PrecursorTacutelymphoblasticleukemia/lymphoma) prolymphocyte(Prolymphocytic) CD30+(Anaplasticlarge-celllymphoma LymphomatoidpapulosistypeA) CutaneousMF+variants indolent:Mycosisfungoides Pagetoidreticulosis Granulomatousslackskin aggressive:Sézarydisease AdultT-cellleukemia/lymphoma Non-MF CD30-:Non-mycosisfungoidesCD30−cutaneouslargeT-celllymphoma PleomorphicT-celllymphoma LymphomatoidpapulosistypeB CD30+:CD30+cutaneousT-celllymphoma SecondarycutaneousCD30+large-celllymphoma LymphomatoidpapulosistypeA Otherperipheral Hepatosplenic Angioimmunoblastic Enteropathy-associatedT-celllymphoma PeripheralT-celllymphomanototherwisespecified(Lennertlymphoma) SubcutaneousT-celllymphoma Byinfection HTLV-1(AdultT-cellleukemia/lymphoma) NKcell/(mostCD56) AggressiveNK-cellleukemia BlasticNKcelllymphoma TorNK EBV(ExtranodalNK-T-celllymphoma/Angiocentriclymphoma) Largegranularlymphocyticleukemia Lymphoid+myeloid Acutebiphenotypicleukaemia Lymphocytosis Lymphoproliferativedisorders(X-linkedlymphoproliferativedisease Autoimmunelymphoproliferativesyndrome) Leukemoidreaction Diffuseinfiltrativelymphocytosissyndrome Cutaneouslymphoidhyperplasia Cutaneouslymphoidhyperplasia withbandlikeandperivascularpatterns withnodularpattern Jessnerlymphocyticinfiltrateoftheskin General Hematologicalmalignancy leukemia Lymphoproliferativedisorders Lymphoidleukemias Authoritycontrol:Nationallibraries France(data) Germany CzechRepublic Retrievedfrom"https://en.wikipedia.org/w/index.php?title=Non-Hodgkin_lymphoma&oldid=1110725348" Categories:Non-HodgkinlymphomaHepatitisCvirus-associateddiseasesLymphomaHiddencategories:CS1errors:genericnameCS1maint:url-statusCS1French-languagesources(fr)ArticleswithshortdescriptionShortdescriptionmatchesWikidataEngvarBfromAugust2019UsedmydatesfromAugust2019ShortdescriptionisdifferentfromWikidataAllarticleswithunsourcedstatementsArticleswithunsourcedstatementsfromAugust2022ArticleswithunsourcedstatementsfromJanuary2018ArticleswithunsourcedstatementsfromNovember2021ArticleswithBNFidentifiersArticleswithGNDidentifiersArticleswithNKCidentifiersWikipediamedicinearticlesreadytotranslate Navigationmenu Personaltools NotloggedinTalkContributionsCreateaccountLogin Namespaces ArticleTalk English Views ReadEditViewhistory More Search Navigation MainpageContentsCurrenteventsRandomarticleAboutWikipediaContactusDonate Contribute HelpLearntoeditCommunityportalRecentchangesUploadfile Tools WhatlinkshereRelatedchangesUploadfileSpecialpagesPermanentlinkPageinformationCitethispageWikidataitem Print/export DownloadasPDFPrintableversion Inotherprojects WikimediaCommons Languages العربيةAsturianuবাংলাCatalàČeštinaCymraegDeutschދިވެހިބަސްEspañolEuskaraفارسیFrançaisGaeilgeՀայերենItalianoעבריתLietuviųBahasaMelayuNederlands日本語ଓଡ଼ିଆPolskiPortuguêsРусскийSimpleEnglishSuomiSvenskaไทยTürkçeУкраїнськаTiếngViệt中文 Editlinks