Although multiple environmental exposures may trigger the development of lymphoma, no single exposure is capable of causing all cases. Differentiation among lymphomas is important. B-cell lymphomas are more commonly associated with chronic infection. T-cell lymphomas are more commonly associated with exposure to environmental pollutants. The development of lymphoma must be regarded as a multifactorial disorder.
By the [World Health Organization (WHO)] classification system, [Worldwide], diffuse large B-cell lymphoma is the most common type of NHL, comprising 85% of NHL. The staging system of the WHO, which classifies tumors based upon their cellular infiltration pattern, is not useful in predicting prognosis, therapy, or risk of development of secondary tumors. By the TNM [Tumor, Nodes, Metastasis] staging system, lymphoma, diffuse usually has a poor prognosis because it has spread to many parts of the body.
Treatment options for lymphoma remain more limited than those for leukemia and [lung cancer](https://www.withpower.com/clinical-trials/lung-cancer), but lymphoma is a common cause of cancer-related death. Patients with indolent non-Hodgkin lymphoma tend to be symptomatic, and aggressive treatment is often employed. Patients with indolent aggressive lymphoma tend to be asymptomatic and are treated with watchful waiting, unless they have evidence of disease progression. Patients with non-Hodgkin lymphoma have multiple options for treatment, ranging from chemotherapy to surgery including radiation therapy. Indolent non-Hodgkin lymphoma usually responds to chemotherapy and, when necessary, can be treated with radiation therapy.
Patients with diffuse lymphoma, such as follicular lymphoma or mantle cell lymphoma, or Burkitt lymphoma, have a cure rate of less than 50%. However, with appropriate therapy, most patients with these types can live a normal life. Patients with a dismal record do not benefit from therapy.
There are about 60,000 people per year who are diagnosed with diffuse large B-cell lymphoma (DLBCL). About 30,000 people a year are diagnosed with systemic DLBCL.
The incidence of lymphoma, diffuse in our family is higher than the prevalence of this disease seen in the general population, and is not age related. Furthermore, the incidence increases with more relapsing events and worsens prognosis, particularly in cases of more advanced-stage disease.
These people who survive this cancer are in good health and, compared with people affected by other forms of cancer, they do not suffer from conditions that cause them to develop a chronic illness. The average age of people affected by lymphoma, diffuse is between 46-53.
Survival with lymphoma, diffuse is good, with more than 5 years survival from diagnosis in 20%, 20%, and 43% for early stage patients, stage III and stage IV patients, and stage III and stage IV patients, respectively.
This is a small exploratory study of immunotherapies combined with conventional chemotherapy in patients with relapsed low-grade non-Hodgkin's lymphoma. Additional larger studies are warranted to verify these results and to explore their predictive value in this disease. Furthermore, the efficacy of this approach in other chemotherapy-refractory lymphoma types and in other indications, e.g. follicular lymphoma, is yet to be studied.
Most of the lymphoma sub-types are highly resistant to chemotherapy. Radiation therapy has not significantly improved cure rates. A new approach may be to target the blood supply of the tumor by use of vascular-targeting agents.
Primary lymphomas arise from the lymphoid precursors that normally make up a portion of the blood and lymph node cells. The most common lymphomas in the United States are NOS. Almost all NOS are B-cell lymphomas, including DLBCL; there are some rare T-cell lymphomas (e.g., extranodal NK/T cell lymphoma) and some rare lymphomas of the lymphocytic type with a high propensity for the CNS, such as large B-cell lymphomas.