Wednesday, November 2, 2011


Lymphoma is when cancer invades the lymphoid cells.  They are usually seen as a solid tumor in the lyphoid cells.

The two main categories for lymphoma are Hodgkin's lymphoma and non-Hodgkin's lymphoma.  Since there was so many lymphomas that have nothing in common they developed a new classification called WHO.  There are four major categories and 70 different lymphomas divided under the four categories. The four major categories are as follows.

Follicular lymphoma in the Bone Marrow

A.  Mature T cell and natural killer (NK) cell neoplasms

B.  Mature B cell neoplasms

C. Hodgkin lymphoma

E. Immunodeficiency-associated lymphoproliferative disorders


The Symptoms of Lymphoma are the following:

*weight loss

*abnormal amount of white cells in urine


* fever of no indicated reason

What lab tests are ordered in diagnosing Lymphoma?

Other laboratory tests that may be useful include:
  • Complete Blood Count (CBC) – may be ordered to rule out non-lymphoma conditions (such as leukemia) and/or to see if anemia is present. A CBC can determine if the platelet count and/or white blood cell count are low, which may indicate that lymphoma is present in the bone marrow.
  • Bone marrow biopsy and examination – used to evaluate the cells present in the bone marrow. The presence of abnormal lymphoid cells and/or lymphoid aggregates may be seen with lymphoma.
  • Blood smear – used to evaluate the quality of red and white blood cells and platelets as well as abnormal cells (lymphocytes), if present. 
  • Immunophenotyping can identify the cells involved by testing for the presence or absence of certain markers on the membrane of the cells or inside the cells. These commonly used markers are called clusters of differentiation (CD) and are listed numerically. By developing a list of the CDs present on the cells, it is possible to classify the cells. This test can be done by several different methods, including flow cytometry and immunohistochemistry.
  • Cytogenetics – an evaluation of the chromosomes in the nucleus of cancer cells to determine if pieces of the chromosomes have moved (translocation). This is rarely used for lymphomas. 
  • Molecular genetic analysis – evaluating the cancer cell's DNA for genetic changes, particularly to determine whether all of the cells belong to a single clone.
  • If it is thought that lymphoma has spread (metastasized) to other areas of the body, analysis of cerebrospinal fluid or other body fluids may be performed. 
  • Beta-2 microglobulin – this test may be used to help predict the prognosis. I there are increased levels of the B2 microglobulin it is indicator of a problem, but not used as a diagnostic tool
Non-laboratory tests
Primarily used to help stage and monitor lymphoma. They include:
  • Physical examination
  • Computed tomography (CT) scans
  • Positron emission tomography (PET) scan
  • Chest X-ray
  • Exploratory surgery (occasionally necessary)
  • Magnetic Resonance Imaging (MRI)
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Four types of Treatment for Lyphoma 

They are Chemotherapy and treated with the drug Rituxan.

RITUXAN® (Rituximab) is indicated for the treatment of patients with:
  • Previously untreated follicular, CD20-positive, B-cell NHL in combination with first-line chemotherapy and, in patients achieving a complete or partial response to RITUXAN in combination with chemotherapy, as single-agent maintenance therapy
  • Non-progressing (including stable disease), low-grade, CD20-positive, B-cell NHL, as a single agent, after first-line CVP chemotherapy
  • Previously untreated diffuse large B-cell, CD20-positive NHL in combination with CHOP or other anthracycline-based chemotherapy regimens
  • Relapsed or refractory, low-grade or follicular, CD20-positive, B-cell NHL as a single agent
People with serious infections should not receive RITUXAN.

Important Safety Information

  • RITUXAN can cause serious side effects that can lead to death, including infusion reactions, tumor lysis syndrome (TLS; kidney failure due to fast breakdown of cancer cells), severe skin and mouth reactions, and progressive multifocal leukoencephalopathy (PML; a rare, serious brain infection).
  • RITUXAN has also been associated with serious and life-threatening side effects, including the return of active hepatitis B virus infection with sudden and serious liver problems including liver failure, and death, other serious infections that can lead to death, heart problems, kidney problems, and stomach and serious bowel problems including blockage and tears in the bowel that can sometimes lead to death.
  • The most common side effects of RITUXAN seen in patients with non-Hodgkin's lymphoma were infusion reactions, fever, chills, low white blood cells, infections, body aches, and tiredness. Before starting treatment with RITUXAN it is important to talk to your doctor about your medical history.
  • Tell your doctor about any side effect that bothers you or that does not go away. These are not all of the possible side effects with RITUXAN. For more information, ask your doctor.
Please see full Prescribing Information, including Medication Guide.
CVP=cyclophosphamide, vincristine, and prednisone or prednisolone; CHOP=cyclophosphamide, doxorubicin, vincristine, and prednisone. Got to website:   http//

When a person is in treatment with Chemotherapy they will have to have blood drawn for a complete blood counts.  Chemo can cause the white cell count and platelet to decrease.  Your white has to be at least 2000 to receive chemo.  If it is not then you have to wait another day to be treated.




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