The Lymphatic System

The lymphatic system is made up of different groups of very little bean-shaped organs known as lymph nodes and lots of thin tubes which run through and connect the lymph nodes all over the body. The lymphatic system carries lymphocytes, which are a type of white blood cell and are a part of the human immune system which helps to fight off germs and foreign bodies in our body system. There are three types of lymphocytes: the B cells, the T cells and the NK cells.

The cells called B cells are B-lymphocytes which are responsible for making the antibodies which fight off bacteria and other forms of infections.

The cells known as the T cell are in fact, T-lymphocytes which are responsible for the destruction of foreign cells and viruses. They are also responsible for triggering the B cells to make antibodies.

The cells called NK cells are Natural killer cells, these cells are responsible for destroying certain intruders, cells infected by invaders and some cancer cells.

Other organs that make up the lymphatic system are: the spleen – filters the blood and makes lymphocytes – the thymus, the tonsils and the bone marrow, which is where the red blood cells, white blood cells and blood platelets are made.

Non-Hodgkin’s Lymphoma

A lymphoma is a form of cancer. It is a cancer of the lymphatic system particularly the white blood cell and it occurs when the healthy B cells, T cells and NK cells begin to change and grow out of control within the lymphatic system, which could lead to the formation of a tumour. When lymphocytes get affected by this disease, they would begin to reproduce at a rapid rate as opposed to dying off naturally and creating space for the growth of new cells. There are different types of lymphoma but the most common are:

Hodgkin’s Lymphoma

Hodgkin’s lymphoma is a rather specific type of lymphoma. It is the rarest of all the types of this disease and is mainly distinguished by the presence of Reed-Sternberg cells. This form of lymphomas is known to have six different subtypes.

Non-Hodgkin’s Lymphoma

Also known as NHL on the other hand, refers to a group of cancers in the lymphatic system. This the most common type of lymphoma and, there are currently about 61 known different types of Non-Hodgkin’s lymphoma. These different groups of cancers can all have different signs, symptoms and finding as well as have different treatments. This form of this disease does not have to do with Reed-Sternberg cells and because of this, there are a variety of methods used in identifying the different types of Non-Hodgkin’s lymphoma.

However, one method of classification is currently been used; it is one that is advised by the WHO and it is largely done on the basis of how the cell appears when looked at under a microscope, the features of the chromosomes of the lymphoma cells, the presence of certain types of proteins and whether the originating source is the B cell or the T cell. With Non-Hodgkin’s lymphoma, it is important to know for certain which subtype you are dealing with as this information would help your doctor to make an informed decision regarding the best form of treatment for you as well as your chances of recovery.

Signs, Symptoms and Treatment of Non-Hodgkin’s Lymphoma

There are a variety of symptoms that can be attributed to this disease however, many people living with some subtypes of Non-Hodgkin’s lymphoma may not experience any symptoms at all. Also, some other conditions which are not lymphoma may be characterised with having some of these symptoms as well. There are only a few symptoms or signs that can be distinctly specific to a case of lymphoma and, this very reason is why this condition is sometimes very difficult to diagnose. In the case of Non-Hodgkin’s lymphoma, the symptoms are largely dependent on the originating source of cancer and the particular organ involved. However, some of the general symptoms attributed to this disease are:

  • Fatigue
  • Development of chills and sweating
  • Enlargement of the liver or spleen
  • The onset of fever which is unexplainable and not linked to any infections or illnesses
  • Loss of weight without any logical or known cause
  • Enlargement of the lymph nodes in the neck, groins, underarms or abdomen

Some of the symptoms of lymphoma which are attributed to a specific location of a tumour are:

  • A tumour located in the spleen can cause some form of back pain and give the feeling of having a full stomach
  • A tumour located in the groin can cause some swelling in the legs
  • A tumour located in the abdomen can cause the belly to be stretched or cause forms of pain in the abdomen or in the back
  • A tumour located in the centre of the chest can press on the trachea leading to cough, chest pains, difficulty breathing and other forms of respiratory issues
  • A tumour located under the arm can cause swelling in the arms
  • In the even that lymphoma spreads to the brain, it can cause a range of symptoms which are similar to that of stroke.

Should a case of Non-Hodgkin’s lymphoma be diagnosed, there are four main treatment types which are recognised and, these treatments are suggested based on these factors: the stage and the type of Non-Hodgkin’s lymphoma, the possible side effects of the treatment and; the preference and overall health of the patient in question.  The treatment methods are:

  • The use of radiation therapy
  • Chemotherapy
  • Targeted therapy, making use of drugs to block certain functions attributed to this disease within the lymphoma cell
  • Immunotherapy, these include: immune checkpoint inhibitors, monoclonal antibodies and CAR T cells

These treatments are often combined for the patient and, often times, both the patient and the doctor may opt for surgery or a stem cell transplant.

Because some patients may not experience any side effects, and therefore not be in need of any immediate form of treatment, the doctor would carry out what is called “watchful waiting”. During this period of watchful waiting, the doctor would keep a close watch on the patients’ condition making use of physical examinations, laboratory tests and CT scan or other forms of imaging tests on a regular basis. In this case, the patients’ treatment would only begin if the patient begins to develop any of the signs or symptoms identified with this disease or if the test results show that the cancer is getting worse.

The rate of Survival and the Factors That Affect the Outlook of Non-Hodgkin’s Lymphoma

Rate of Survival

When looking at the statistics of the rate of survival for people with Non-Hodgkin’s lymphoma, it is important to remember that these statistics are just an estimate. It is also important to note that these estimates are as a result of the annual data collected on the basis of the number of patients with this disease. Furthermore, it is also important to note that survival statistics are measured by experts every five years and so, the estimates that are shown may in fact, not show any of the results of better diagnosis or a better treatment plan that has been available for less than five years.

Survival rates or rates of survival are statistics that give you information concerning the number of people who have the same type and stage of cancer and, are still alive within a certain amount of time after they are diagnosed. This information cannot tell you for how long they will remain alive with this condition but, it can, however, help to give you a better idea of how possible it is for the treatment to be successful.

According to statistics, about 80% of people survive cancer for a year or more after diagnosis, about 70% of people survive for about five years or more after diagnosis and about 65%of people survive cancer for ten years or more after diagnosis.

In the case of Non-Hodgkin’s lymphoma, the survival rates have been divided into survival for the low grade and for the high-grade Non-Hodgkin’s lymphoma

Low Grade

These low-grade lymphomas are quite difficult to eradicate completely however, they can still be kept marginally, under control for a number of years.

Follicular Lymphoma

This is the most commonly known form of low-grade lymphoma

Stage 1: Statistics show that about 90% of people survive for five years or more after diagnosis.

Stage 2: Statistics show that almost 90% of people survive for five years or more after diagnosis

Stage 3 and Stage 4: Statistics show that almost 80% of people survive for five years or more after diagnosis

Marginal Zone Lymphoma

Stage 1: Statistics show that about 80% of people survive for five years or more after diagnosis

Stage 2: Statistics show that about 75% of people survive for five years or more after diagnosis

Stage 3: Statistics show that about 50% of people survive for five years or more after diagnosis

Stage 4: Statistics show that more than 50% of people survive for five years or more after diagnosis

High-Grade Lymphoma

In the case of high-grade lymphoma, they are quite aggressive and generally require a more intensive level of treatment than the low-grade lymphoma. However, they usually respond rather positively to treatments and so, many patients have been known to have been cured.

Diffuse Large B Cell Lymphoma

Stage 1: Statistics show that about 65% of people survive for five years or more after diagnosis

Stage 2: Statistics show that about 70% of people survive for five years or more after diagnosis

Stage 3: Statistics show that over 50% of people survive for five years or more after diagnosis

Stage 4: Statistics show that almost 50% of people survive for five years or more after diagnosis

Burkitt Lymphoma

This type of lymphoma is rare and grows quite rapidly. Even though there is no stage by stage statistic of a rate of survival of this condition, there is an overall statistic which shows that about 60% of people with Burkitt lymphoma survive for five years or more after diagnosis.

Generally, the overall relative five-year rate of survival for people with Non-Hodgkin’s lymphoma is 71% although, it is important and should be noted that the rates of survival can widely vary depending on the different types and the different stages of lymphoma. Even at that, depending on the type of lymphoma, the stage may not be very helpful in determining the potential outlook of the patient and in cases like this, some other factors may be of help to give the doctor a better idea of the outlook of the patient.

Factors That Affect the Outlook of Non-Hodgkin’s Lymphoma

Generally, the outlook of this condition can be determined based on the stage of the lymphoma as at when it is diagnosed. The stage of lymphoma gives information regarding how many parts of the body have already been affected by the disease. The type and grade of the lymphoma also affect the level of survival. The grade simply means the level of abnormality of the lymphoma cell as seen under the microscope. Despite these, there are also a number of other factors which can affect the outlook of lymphoma:

Age: It is known that being under the age of 60 is a factor that can greatly increase the chances of survival

Stage: Being diagnosed in the early stages of lymphoma have also been known to have an effect in the increased chances of survival

Haemoglobin level: Having a low haemoglobin level has been a known contributing factor to non-survival

Serum lactate dehydrogenase level: A low blood level of this enzyme has been associated with increased chances of survival

Affected areas: It has been known that the less number of areas affected, the higher the chances of survival.

These factors are used by doctors to reach a guided conclusion on the possible outlook of the patient in question and although these are not a guarantee of survival, they can help you be more guided on the possibility of survival.