Cancer: Non-Hodgkin's lymphoma
Anyone who thinks about cancer often imagines malignant tumors that affect organs such as the lungs, the breast, the intestine and the prostate. However, blood constituent cells may also become malignant, as in the case of non-Hodgkin's lymphoma. The treatment of this condition has improved significantly in recent years.
Professor Fritz Offner (hematologist at UZ Gent) gives us some explanations.
What is non-Hodgkin's lymphoma?
Fritz Offner: Non-Hodgkin lymphomas include a group of malignant diseases that originate in white blood cells. It is a type of white blood cells, in this case lymphocytes, whose mission is to help ensure a defense against all kinds of microbes, such as bacteria and viruses. During the defense phase, lymphocytes increase for a period of 8 to 10 days. In the case of non-Hodgkin's lymphoma, this phenomenon does not go as planned. Cells continue to increase or remain alive much longer, resulting in their accumulation at the lymph nodes.
"This disease is not so common: every year, about 16 people out of 100,000 are affected." There are 18 types of non-Hodgkin lymphomas. The most common forms are large B-cell diffuse lymphoma, which is aggressive, and follicular lymphoma, which evolves more slowly.
What are the symptoms?
"They can be very variable. In aggressive forms, lymph nodes are observed that grow rapidly, which can be accompanied by fatigue, sweating, fever and weight loss. In other cases, the lymph nodes grow slowly, and it takes months or even years before the symptoms appear.
How is the disease treated?
The large-cell diffuse type is treated with a combination of conventional chemotherapy and more recent targeted antibodies, the goal being to completely cure the disease with a series of six to eight cures. Currently, this treatment yields results in 60 to 80% of patients.
"Follicular lymphomas may also often disappear with similar treatment, but they tend to re-offend, and in this case repeated treatments are necessary." Continuous treatment with targeted antibodies only delays the recurrence. In this way, 80% of patients will be doing very well.
"Chemotherapy is administered at the day hospital in three-week intervals. Previously, targeted therapy was administered using slow perfusion, but now subcutaneous forms allow for much shorter and more comfortable treatment.
A promising development
Thanks to the new techniques that have been developed over the last 15 years, we can now cure a large majority of patients with diffuse large cell lymphomas. Patients with follicular lymphoma, who respond well to treatment, have in the first ten years almost the same life expectancy as non-sick people. Even if we cannot heal everyone yet, no one doubts that new chapters will be written as part of the treatment of these ailments.
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