Non Hodgkins Lymphoma 1

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NonNon--Hodgkin¶sHodgkin¶s

LymphomaLymphoma

Michael HakimMichael Hakim

Bio 316Bio 316August 5, 2004August 5, 2004



LymphomaLymphoma

History and OverviewHistory and Overview

StatisticsStatistics

What it effects (biology)What it effects (biology) Classification and StagingClassification and Staging

SymptomsSymptoms

Causes and Risk FactorsCauses and Risk Factors Diagnosis and TreatmentDiagnosis and Treatment



Lymphoma¶sLymphoma¶sWhere They BeginWhere They Begin

Lymphomas are aLymphomas are acancer of thecancer of thelymphatic systemlymphatic system

�� Lymphatic vesselsLymphatic vessels

�� Lymph nodesLymph nodes(underarms, groin,(underarms, groin,neck, spleen,neck, spleen,

tonsils and bonetonsils and bonemarrow)marrow)



Lymphoma¶sLymphoma¶sWhere They BeginWhere They Begin

The Lymphatic system is our bodiesThe Lymphatic system is our bodiesmain fight against infectionmain fight against infection

Lymphocytes (BLymphocytes (B--cell and Tcell and T--cell)cell)�� Carried through our lymphatic systemCarried through our lymphatic system

and help our bodies fight infectionand help our bodies fight infection

�� Lymphocytes are carried through theLymphocytes are carried through thelymph vessels as well as the bloodlymph vessels as well as the bloodstream, so cancer can start in nodesstream, so cancer can start in nodesand spread anywhere throughout theand spread anywhere throughout thebody.body.



Lymphatic SystemLymphatic System

American MedicalAssociation



NonNon--Hodgkin¶s LymphomaHodgkin¶s Lymphoma

StatisticsStatisticsfor 2004for 2004

54,370 new cases54,370 new cases

19,410 deaths19,410 deaths�� In California Alone there are est. 5,550 newIn California Alone there are est. 5,550 new

cases and a Death rate of 1,730 (California hascases and a Death rate of 1,730 (California hasthe highest incidence and Death rate for Nonthe highest incidence and Death rate for Non--Hodgkin¶s LymphomaHodgkin¶s Lymphoma

�� NonNon--Hodgkin¶s Lymphoma is the 6Hodgkin¶s Lymphoma is the 6thth and 7and 7thth

most deadly cancers for men and womenmost deadly cancers for men and women

�� Recent studies have shown that overweightRecent studies have shown that overweightpatients are more likely to die then thosepatients are more likely to die then thosepatients who are in better shape.patients who are in better shape.



ClassificationClassification

Usually classified by how the cellsUsually classified by how the cellslook under a microscope and howlook under a microscope and how

quickly they grow and spreadquickly they grow and spread�� Aggressive lymphomas (highAggressive lymphomas (high--gradegradelymphomas)lymphomas)

�� Indolent Lymphomas (lowIndolent Lymphomas (low--gradegradelymphomas)lymphomas)



NonNon--Hodgkin¶s LymphomaHodgkin¶s Lymphoma

Two main types of NonTwo main types of Non--Hodgkin¶sHodgkin¶sLymphoma:Lymphoma:

BB--Cell and TCell and T--Cell LymphomasCell Lymphomas

��BB--Cell lymphomas (80%)Cell lymphomas (80%)��TT--Cell lymphomas (15%)Cell lymphomas (15%)



BB--Cell Lymphoma (80%)Cell Lymphoma (80%)

BB--Cells help make antibodies, which areCells help make antibodies, which areproteins that attach to and help destroyproteins that attach to and help destroyantigensantigens

Lymphomas are caused when a mutationLymphomas are caused when a mutationarises during the Barises during the B--cell life cyclecell life cycle

Various different lymphomas can occurVarious different lymphomas can occurduring several different stages of the cycleduring several different stages of the cycle

�� Follicular lymphoma, which is a type of BFollicular lymphoma, which is a type of B--cellcelllymphoma is caused by a gene translocationlymphoma is caused by a gene translocationwhich results in an over expressed gene calledwhich results in an over expressed gene calledBCLBCL--2, which blocks apoptosis.2, which blocks apoptosis.



BB--Cell CancersCell Cancers



TT--Cell Lymphoma (15%)Cell Lymphoma (15%)

The TThe T--cells are born from stem cells,cells are born from stem cells,similar to that of Bsimilar to that of B--cells, but maturecells, but maturein the thymus.in the thymus.

They help the immune system workThey help the immune system workin a coordinated fashion.in a coordinated fashion.�� These types of lymphomas areThese types of lymphomas are

categorized by how the cell is affectedcategorized by how the cell is affected Anaplastic Large cell Lymphoma, tAnaplastic Large cell Lymphoma, t--cellcell

lymphoma caused by a gene translocation inlymphoma caused by a gene translocation inchromosome 5chromosome 5

Lymphoma.org



SymptomsSymptoms

Painful Swelling of lymph nodesPainful Swelling of lymph nodeslocated in the neck, underarm andlocated in the neck, underarm andgroin.groin.

Unexplained FeverUnexplained Fever

Night SweatsNight Sweats

Constant FatigueConstant Fatigue Unexplained Weight lossUnexplained Weight loss

Itchy SkinItchy Skin

Cancer Sourcebook



Causes and Risk FactorsCauses and Risk Factors

The Exact causes are still unknownThe Exact causes are still unknown

�� Higher risk for individuals who:Higher risk for individuals who:

Exposed to chemicals such as pesticides orExposed to chemicals such as pesticides orsolventssolvents

Infected w/ EpsteinInfected w/ Epstein--Barr VirusBarr Virus

Family history of NHL (although noFamily history of NHL (although nohereditary pattern has been established)hereditary pattern has been established)

Infected w/ Human Immunodeficiency VirusInfected w/ Human Immunodeficiency Virus(HIV)(HIV)

Lymphoma.org



DiagnosisDiagnosis

XX--RaysRays

CT scansCT scans

Magnetic Resonance Imaging (MRI)Magnetic Resonance Imaging (MRI) BiopsyBiopsy

LymphangiogramLymphangiogram

�� Pictures of the lymphatic system takenPictures of the lymphatic system takenw/ xw/ x--ray after a special dye is injectedray after a special dye is injectedto illuminate lymph nodes and vesselsto illuminate lymph nodes and vessels



Treatment OptionsTreatment Options

ChemotherapyChemotherapy

RadiationRadiation

Bone Marrow TransplantationBone Marrow Transplantation SurgerySurgery

Bortezomib (Velcade)Bortezomib (Velcade)

ImmunotherapyImmunotherapy Using the bodies own immune systemUsing the bodies own immune system

combined with material made in a lab.combined with material made in a lab.



Survival RatesSurvival Rates

Survival Rates vary widely by cellSurvival Rates vary widely by celltype and staging.type and staging.

�� 1 Year Survival Rate: 77%1 Year Survival Rate: 77%



Cancer.org



Any Questions? Any Questions?

Non Hodgkins Lymphoma 1

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