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Lymphoma

(Finalized march 2005)

What is lymphoma?

Lymphoma is a cancer of the lymphatic system of the body.
The lymphatic system of the body includes lymphatic vessels, lymph nodes, tonsils, the spleen and the thymus. These organs and tissues contain a type of white blood cell called lymphocytes.
There are two types of lymphocytes—T cells and B cells. Both are responsible for fighting diseases and infections in the body. Lymphoma is usually caused by abnormal production and growth of the B lymphocytes.

How does lymphoma affect people with HIV/AIDS?

There are two main types of lymphomas: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma (NHL). NHL is the most common type of lymphoma seen in people with HIV/AIDS.
In people with HIV/AIDS, lymphoma is linked to immune deficiency. When the immune system becomes weak, the B lymphoctyes in the body may become overactive and grow at an abnormal rate to become lymphoma.
Although lymphoma can occur at any CD4 (T-cell) count, it is much more common in people who have less than 100 CD4+ cells.

What are the signs and symptoms of lymphoma?

Symptoms of lymphoma depend on the part(s) of the body affected. Lymphoma can occur in many parts of the body, including the lymph nodes, spleen, liver, digestive system or brain.
The most common symptoms of lymphomas include fever, night sweats, weight loss, unexpected tiredness and swollen lymph glands throughout the body. In lymphoma affecting the brain and spinal cord (the central nervous system), symptoms can include headaches, confusion, memory loss, seizures and loss of speech or other body functions.

How is lymphoma diagnosed?

Lymphoma is usually diagnosed by removing a sample of tissue from the affected area for analysis. This is called a biopsy. Lymphoma of the central nervous system may be diagnosed by a CT-scan or MRI scan of the head.
Biopsy will confirm the presence of cancer cells and can give information on how quickly the cancer cells are growing.
Based on the speed of cancer cell growth, the lymphoma is classified as low grade (slowly spreading), immediate grade (spreading more quickly) or high grade (spreading very aggressively).
Once lymphoma is confirmed through a biopsy, other tests are done to find out how far the lymphoma has spread. This process is called staging and helps determine what treatment is best for the lymphoma.
Staging of the cancer is done with the help of X-rays, bone marrow biopsies, lumbar puncture, CT-scans or MRI scans that can show the extent to which the lymphoma has spread to different parts of the body.

How can lymphoma be treated?

Treatment for lymphoma will depend on several factors:

1. the type of lymphoma
2. how far it has spread
3. how quickly it is growing
4. the overall health of the person, especially his or her immune status

Treatment for lymphoma is similar to that for other cancers: chemotherapy with a combination of anti-cancer drugs, or radiotherapy with X-rays or other forms of radiation, or a combination of both types of treatments.
These treatments can have very strong side effects and can further weaken the immune system. Doses may need to be reduced if the person’s immune system is very weak. Other medications may be necessary to help reduce the unpleasant side effects and to prevent complications of opportunistic infections.
Talk to your cancer doctor about taking anti-HIV medications while your lymphoma is being treated. Anti-HIV medications may help improve your immune system and your chance of survival.

How can lymphoma be prevented?

There is no specific way to prevent lymphoma. However, since lymphoma is related to a weakened immune system, taking anti-HIV medications to maintain a healthy immune system is the most effective way for people with HIV/AIDS to prevent lymphoma.