09/15/2021 at 8:30 AM CEST
Lymphoma is the most common type of blood cancer in the population. Although there are no regulated epidemiological analyzes in Spain, the Spanish Network of Cancer Registries (REDECAN) estimates that 10,000 new cases of lymphoma are diagnosed each year.
Lymphoma is a type of hematological cancer caused by the malignant proliferation of lymphocytes (defensive cells of the immune system), which usually begins in the lymph nodes.
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So far its causes are not known, therefore, there is no type of preventive measure that can be carried out.
The average age of onset, according to the Spanish Society of Hematology and Hemotherapy (SEHH), is 60 years. The good news is that up to 60% of lymphoma cases are cured.
The most common signs that lymphocytes are multiplying abnormally are:
Swollen lymph nodes (adenopathies) located in the neck, armpits, or groin. This increase in size is due to the fact that the disease usually begins in these nodes. The patient has a high fever, above 38 degrees. Excessive sweating at night. Unexplained weight loss. Specifically, 10% is lost in just 6 months Other local manifestations: peripheral lymphadenopathy, enlarged spleen, etc.
More than 60 types of lymphoma
According to the World Health Organization there are more than 60 types of lymphoma. The difference between them is in the type of immune cells that are affected and the biomarkers involved.
Despite this great variety, the SEHH experts establish two large groups:
Hodgkin lymphomas. It represents 10% of the lymphomas that are diagnosed. It is more common among young people (15 to 35 years old) and older people (between 50 and 70 years old). Fortunately, most patients manage to overcome Non-Hodgkin’s Lymphomas. They constitute 90% of lymphomas. They mainly affect people over 65 years of age.
Regardless of the type of lymphoma, its evolution is very different in each patient, and this also allows specialists to distinguish between the different types of lymphoma. indolent lymphomas or the aggressive ones.
Indolents are, according to hematologists, slow growing. There are patients who, without receiving any type of treatment, live for many years without presenting complications.
What’s more, in some cases, specialists recommend not starting any treatment until symptoms develop.
On the opposite side are the aggressive lymphomas, that evolve quickly and that if left untreated can reduce the life expectancy of the patient to a few months or weeks.
The most common approach to aggressive lymphomas is through immuno-chemotherapy. And, fortunately, the vast majority of patients respond well to treatment, even being cured.
The best known of this aggressive hematological cancer is diffuse large B-cell lymphoma (DLBCL).
Diagnosis and treatment
Once the warning symptoms of this pathology appear, specialists will determine the presence of lymphoma through different diagnostic tests:
Examination of lumps or adenopathies Biopsy of swollen lymph nodes Blood tests Serology Chest X-ray CT of neck, chest, abdomen and pelvis Positron emission tomography (PET) Bone marrow aspirate and biopsy.
Once the diagnosis is made, the treatment that the patient will receive will depend on the type of lymphoma that he suffers and on the stage in which he is. Among the most used techniques are:
Polychemotherapy Monoclonal antibodies Radiochemotherapy Hematopoietic stem cell transplantation (bone marrow transplantation)
Lymphoma and Covid-19
At the last congress of the American Association of Hematology (ASH), the Spanish Hematopoietic Transplant Group (GETH), of the Spanish Society of Hematology and Hemotherapy (SEHH), presented a study that showed a mortality of 35% in hematological patients with Covid-19 pneumonia.
This figure increased in those patients who had active disease at the time of infection.
In the specific case of lymphomas, the Spanish Lymphoma Group (GELTAMO) has launched its own study that collects data from more than 200 patients and confirms the severity of this infection in this group.
Therefore, specialists insist on the need to prevent it with environmental safety and vaccines.
With regard to immunization against COVID-19, María Dolores Caballero Barrigón, president of the GELTAMO Foundation, sees “logical” the refusal of the European Medicines Agency (EMA) to administer, for now, a third dose to the population general and reserve it for people whose immune system has problems.
At the SEHH “the effectiveness of vaccination is being studied in nearly 400 patients receiving hematopoietic stem cell transplantation (HSCT) and / or CAR-T cells, some of them with lymphoma,” the expert points out.
This research shows how “lymphoma patients who have received CAR-T therapy appear to have a worse response to the vaccine than other hematological patients.” Although these data have to be confirmed, “they are an important starting point.”