Lymphoma is cancer that starts in the lymphocytes, a type of white blood cell of the human immune system. Lymphoma is the most common kind of blood cancer. It includes both Hodgkin’s lymphoma and non-Hodgkin’s lymphoma, depending on the specific type of lymphocyte involved.
T-cell lymphoma is a type of Non-Hodgkin’s lymphoma which comes in many forms.
Types of Lymphoma
T-lymphoblastic lymphoma/leukemia: This disease is very common in teens or young adults, with chances of males being affected more than females. It can be considered either a lymphoma or a type of acute lymphoblastic leukemia (ALL), depending on how much of the bone marrow is involved (leukemias have more bone marrow involvement).
It often starts in the thymus (a small organ behind the breastbone and in front of the heart, which is where many T cells are made), and may grow into a large tumor in the mediastinum (the area between the lungs). This may cause trouble in breathing and swelling of the arms and face.
Peripheral T-cell lymphomas: These are uncommon types of lymphoma that develop from more mature forms of T cells.
Adult T-cell leukemia/lymphoma: This lymphoma is caused by infection with a virus called HTLV-1. It affects the bone marrow (where new blood cells are made), lymph nodes, spleen, liver, skin, and other organs.
Cutaneous T-cell lymphomas: These lymphomas start in the skin. Skin lymphomas account for about 5% of all lymphomas.
Angioimmunoblastic T-cell lymphoma: This lymphoma accounts for about 4% of all lymphomas. It is more common in old age. It involves lymph nodes and bone marrow as well as the spleen or liver, which can get enlarged. People with this lymphoma usually have a fever, weight loss, skin rashes, and often develop infections.
Extranodal natural killer/T-cell lymphoma, nasal type: This rare type of lymphoma involves the upper airway passages, mostly the nose and upper throat, but it can also invade the skin, digestive tract, and other organs. Cells of this lymphoma are similar in some ways to natural killer (NK) cells, another type of lymphocyte.
Enteropathy-associated intestinal T-cell lymphoma (EATL): EATL is a lymphoma that grows in the lining of the intestine. This lymphoma is common in the small intestine, but it can also appear in the colon.
This lymphoma occurs in people with celiac disease (also known as gluten-sensitive enteropathy). Celiac disease is an autoimmune disease in which eating gluten causes the immune system to attack the lining of the intestine and other parts of the body. It is rare in people who have had celiac disease since childhood and is more common in people diagnosed as older adults. This lymphoma is more common in men than in women.
Anaplastic large cell lymphoma (ALCL): About 2% of lymphomas are of this type. It is more common in young people (including children), but it can affect older adults as well. This type of lymphoma tends to grow rapidly, but many people with this lymphoma can be cured.
There are different forms of anaplastic large cell lymphoma.
Primary cutaneous ALCL affects only the skin. This is discussed in more detail in lymphoma of the skin.
Systemic ALCL can affect lymph nodes and other organs, including the skin.
Systemic ALCL is divided into 2 types based on whether the lymphoma cells have mutations in the ALK gene.
ALK-positive and ALK-negative types.
symptoms
Symptoms vary according to the specific type of T-cell lymphoma.
Symptoms of mycosis fungoides include flat, scaly skin patches, thick raised plaque tumors that may or may not develop into ulcers, and itching.
Signs and symptoms of Sézary syndrome are red, itchy rashes that cover most of the body and eyelids. Nails and hair changes, enlarged lymph nodes, edema or swelling.
Not all forms of T-cell lymphoma cause symptoms on the skin. Other reasons may be:
bleeding or bruising easily
recurrent infections
fever or chills for no known reason
fatigue
Persistent abdominal pain on the left side due to swelling of the spleen
fullness of stomach
frequent urination
Constipation
Treatment of myeloma
It is very likely to receive more than one type of therapy. There are a large number of such hospitals in India which can be considered as the best lymphoma treatment hospital in India.
Mycosis fungoides and Sézary syndrome may include direct treatment on the skin as well as systemic treatments.
Skin treatment
Some ointments, creams and gels applied directly to the skin can control symptoms and even destroy cancer cells.
Retinoids (vitamin A-derived drugs). Possible side effects are itching, burning and sensitivity to sunlight. Retinoids should not be used during pregnancy.
Corticosteroids. Long-term use of topical corticosteroids may cause thinning of the skin.
Topical chemotherapy. This may include redness and swelling. It can also increase the risk of other types of cancer. However, topical chemotherapy has fewer side effects than oral or intravenous chemotherapy.
Systemic Treatment
Medications for T-cell lymphoma include pills, injections, and intravenous drugs. Targeted therapy and chemotherapy drugs are often combined for maximum treatment.
Systemic treatment may include:
chemotherapy the combination called CHOP, which includes cyclophosphamide, vincristine, and prednisone
newer chemo drugs, such as pralatrexate (Folotin)
targeted drugs, such as bortezomib (Velcade), belinostat (Beleodac), or romidepsin (Istodax)
immunotherapy drugs, such as alemtuzumab (Campath) and danileukin difficile (Ontak)
In advanced cases, one may require maintenance chemotherapy for up to two years.
light therapy
UVA and UVB light can kill cancer cells on the skin. Light therapy is usually given several times a week using special lamps. UVA light treatment is usually combined with drugs called Psoralens. UVA light activates Psoralens to kill cancer cells.
radiation
Radiation therapy uses radioactive particles to destroy cancer cells. The beam can be directed at the affected skin so that the internal organs are not affected.
Extracorporeal photopheresis
It is used to treat mycosis fungoides or Sézary syndrome. The two-day procedure, in which the blood will be removed and treated with UV light and drugs that activate when exposed to light, kill the cancer cells.
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