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Non-Hodgkin Lymphoma: Symptoms, Diagnosis, and Treatment Options
Health Conditions with Similar Symptoms to Non-Hodgkin Lymphoma
Hodgkin Lymphoma
Definition: Hodgkin lymphoma is a type of cancer that begins in the lymphatic system, which is part of the immune system. It specifically affects lymphocytes, a kind of white blood cell. Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells, large abnormal cells that can be seen under a microscope.
How to Know if You Might Have Hodgkin Lymphoma vs Non-Hodgkin Lymphoma
Both Hodgkin and Non-Hodgkin lymphoma share symptoms such as swollen lymph nodes, fatigue, fever, night sweats, and unexplained weight loss. However, Hodgkin lymphoma is identified by the presence of Reed-Sternberg cells, which are not found in Non-Hodgkin lymphoma. Hodgkin lymphoma often begins in the upper body, such as the chest, neck, or underarms, while Non-Hodgkin lymphoma can start in lymph nodes anywhere in the body.
Another distinguishing feature is that Hodgkin lymphoma may cause pain in the lymph nodes after consuming alcohol, a symptom not typically associated with Non-Hodgkin lymphoma. A lymph node biopsy is the most definitive way to differentiate between the two. If Reed-Sternberg cells are present, it suggests Hodgkin lymphoma. Blood tests, imaging scans, and bone marrow biopsies can also assist in diagnosis.
Chronic Lymphocytic Leukemia (CLL)
Definition: Chronic lymphocytic leukemia (CLL) is a cancer that affects the blood and bone marrow, primarily involving B lymphocytes. CLL progresses slowly and is most commonly diagnosed in older adults.
How to Know if You Might Have Chronic Lymphocytic Leukemia vs Non-Hodgkin Lymphoma
CLL and Non-Hodgkin lymphoma can both cause swollen lymph nodes, fatigue, and night sweats. However, CLL often presents with elevated white blood cell counts, which can be detected through routine blood tests, while Non-Hodgkin lymphoma may not. CLL also tends to progress more slowly than many forms of Non-Hodgkin lymphoma, which can be more aggressive.
CLL frequently leads to an enlarged spleen or liver, causing discomfort or a feeling of fullness in the abdomen, which is less common in Non-Hodgkin lymphoma. Blood tests, including a complete blood count (CBC), can help distinguish CLL from Non-Hodgkin lymphoma. In CLL, the CBC will show an abnormally high number of lymphocytes. A bone marrow biopsy or flow cytometry may confirm the diagnosis.
Multiple Myeloma
Definition: Multiple myeloma is a cancer that affects plasma cells, a type of white blood cell found in the bone marrow. Plasma cells produce antibodies that help fight infections. In multiple myeloma, abnormal plasma cells multiply uncontrollably, leading to bone damage, kidney problems, and a weakened immune system.
How to Know if You Might Have Multiple Myeloma vs Non-Hodgkin Lymphoma
Both multiple myeloma and Non-Hodgkin lymphoma can cause fatigue, bone pain, and frequent infections. However, multiple myeloma is more likely to result in bone fractures, high calcium levels (hypercalcemia), and kidney issues, which are not typical in Non-Hodgkin lymphoma. Multiple myeloma often leads to anemia, causing symptoms like shortness of breath and dizziness.
To differentiate, doctors may perform blood tests to check for abnormal proteins produced by myeloma cells, such as M proteins or Bence-Jones proteins. A bone marrow biopsy can confirm multiple myeloma by showing an increased number of plasma cells. Imaging tests, such as X-rays or MRIs, may reveal bone damage, which is more characteristic of multiple myeloma than Non-Hodgkin lymphoma.
Acute Lymphoblastic Leukemia (ALL)
Definition: Acute lymphoblastic leukemia (ALL) is a rapidly progressing cancer that affects the blood and bone marrow, primarily involving immature white blood cells called lymphoblasts. ALL is most common in children but can also occur in adults. It progresses quickly and requires prompt treatment.
How to Know if You Might Have Acute Lymphoblastic Leukemia vs Non-Hodgkin Lymphoma
ALL and Non-Hodgkin lymphoma can both cause symptoms like fatigue, fever, and swollen lymph nodes. However, ALL often presents with more severe symptoms, including frequent infections, easy bruising or bleeding, and bone or joint pain, which are less common in Non-Hodgkin lymphoma. ALL can also cause a very high white blood cell count, which is not always seen in Non-Hodgkin lymphoma.
Blood tests, including a complete blood count (CBC), can help distinguish ALL from Non-Hodgkin lymphoma. In ALL, the CBC will show a high number of immature white blood cells (lymphoblasts). A bone marrow biopsy is essential for diagnosing ALL, as it will reveal a large number of lymphoblasts in the bone marrow. Imaging tests, such as CT scans or MRIs, may be used to check for disease spread, but blood and bone marrow tests are the most definitive.
Reactive Lymphadenopathy
Definition: Reactive lymphadenopathy refers to the swelling of lymph nodes in response to infection, inflammation, or other non-cancerous conditions. It is a common and usually temporary condition that occurs when lymph nodes enlarge as they work to fight infections or other immune responses.
How to Know if You Might Have Reactive Lymphadenopathy vs Non-Hodgkin Lymphoma
Both reactive lymphadenopathy and Non-Hodgkin lymphoma can cause swollen lymph nodes. However, in reactive lymphadenopathy, the swelling is usually temporary and occurs in response to an infection or inflammation, such as a cold, flu, or skin infection. The lymph nodes may be tender to the touch, which is less common in Non-Hodgkin lymphoma.
In contrast, swollen lymph nodes in Non-Hodgkin lymphoma are often painless and may persist or grow over time. Blood tests, such as a complete blood count (CBC), can help identify if an infection is present, suggesting reactive lymphadenopathy. A biopsy of the lymph node may be necessary if the swelling does not resolve or if there are other concerning symptoms, such as unexplained weight loss or night sweats, to rule out Non-Hodgkin lymphoma.
Autoimmune Disorders
Definition: Autoimmune disorders occur when the immune system mistakenly attacks the body’s own tissues. Common autoimmune diseases include lupus, rheumatoid arthritis, and Sjögren’s syndrome. These conditions can cause a wide range of symptoms, depending on which part of the body is affected.
How to Know if You Might Have an Autoimmune Disorder vs Non-Hodgkin Lymphoma
Both autoimmune disorders and Non-Hodgkin lymphoma can cause symptoms like fatigue, swollen lymph nodes, and fever. However, autoimmune disorders often cause additional symptoms not typically seen in Non-Hodgkin lymphoma, such as joint pain, skin rashes, and dry eyes or mouth (in the case of Sjögren’s syndrome).
Blood tests can help differentiate between autoimmune disorders and Non-Hodgkin lymphoma. For example, tests for specific autoantibodies, such as antinuclear antibodies (ANA) or rheumatoid factor (RF), can indicate the presence of an autoimmune disorder. In contrast, a lymph node biopsy may be necessary to confirm a diagnosis of Non-Hodgkin lymphoma. Imaging tests, such as CT scans or MRIs, may also be used to assess lymph node involvement in both conditions.
Treatment Options for Non-Hodgkin Lymphoma
Medications
Rituximab: Rituximab is a monoclonal antibody that targets the CD20 protein on B-cells, which are often involved in Non-Hodgkin lymphoma (NHL). It helps the immune system destroy these cancerous B-cells.
Rituximab is commonly used as a first-line treatment for B-cell lymphomas, either alone or in combination with chemotherapy. It is administered intravenously in cycles, depending on the lymphoma’s stage and type.
Patients can expect tumor size reduction and symptom relief within weeks to months. Rituximab has been shown to improve survival rates, especially when combined with other therapies.
Cyclophosphamide: Cyclophosphamide is a chemotherapy drug that interferes with the DNA of cancer cells, preventing their growth and division.
It is often part of combination chemotherapy regimens, such as CHOP (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone), and is used in both early and advanced stages of NHL.
Patients may experience tumor shrinkage and symptom relief within weeks of starting treatment. However, side effects like nausea and hair loss are common.
Doxorubicin: Doxorubicin is an anthracycline chemotherapy drug that damages the DNA of cancer cells, leading to cell death.
It is a key component of the CHOP regimen and is used in aggressive forms of NHL. Doxorubicin is administered intravenously in cycles, usually every 3 weeks.
Patients often see tumor size reduction and symptom improvement within a few treatment cycles. However, it can cause side effects like fatigue and heart damage, so it’s closely monitored.
Vincristine: Vincristine is a chemotherapy drug that inhibits cancer cell division by disrupting the formation of microtubules, which are essential for cell division.
Vincristine is another component of the CHOP regimen and is used in both aggressive and indolent forms of NHL. It is administered intravenously in cycles.
Patients may experience tumor shrinkage and symptom relief, but side effects like nerve damage (neuropathy) can occur.
Prednisone: Prednisone is a corticosteroid that reduces inflammation and suppresses the immune system, helping control lymphoma cell growth.
It is often used in combination with chemotherapy drugs, like in the CHOP regimen. Prednisone is taken orally and is usually prescribed for a short period during each treatment cycle.
Patients typically experience rapid symptom relief, such as reduced swelling and pain, but long-term use can lead to side effects like weight gain and high blood sugar.
Bendamustine: Bendamustine is a chemotherapy drug that damages the DNA of cancer cells, preventing them from dividing and growing.
It is often used in patients with indolent (slow-growing) forms of NHL or in cases where the disease has relapsed after initial treatment. It can be administered alone or in combination with other drugs.
Patients may see tumor shrinkage and symptom improvement within weeks, but side effects like low blood cell counts and fatigue are common.
Ibrutinib: Ibrutinib is a targeted therapy that blocks a protein called Bruton’s tyrosine kinase (BTK), which is involved in the growth and survival of B-cells.
It is typically used in patients with relapsed or refractory B-cell lymphomas, especially those who have not responded to other treatments. Ibrutinib is taken orally as a daily pill.
Patients may experience tumor size reduction and symptom relief within months, but side effects like diarrhea and fatigue can occur.
Obinutuzumab: Obinutuzumab is a monoclonal antibody that targets the CD20 protein on B-cells, similar to Rituximab, but with a slightly different mechanism of action.
It is often used in patients with relapsed or refractory NHL, particularly in combination with chemotherapy. Obinutuzumab is administered intravenously in cycles.
Patients may experience tumor shrinkage and symptom relief, but side effects like infusion reactions and low blood cell counts are possible.
Alemtuzumab: Alemtuzumab is a monoclonal antibody that targets the CD52 protein on the surface of both B-cells and T-cells, helping the immune system destroy these cancerous cells.
It is typically used in patients with T-cell lymphomas or in cases where other treatments have failed. Alemtuzumab is administered intravenously or subcutaneously.
Patients may experience tumor size reduction and symptom relief, but side effects like infections and low blood cell counts are common.
Lenalidomide: Lenalidomide is an immunomodulatory drug that enhances the immune system’s ability to fight cancer cells and inhibits the growth of blood vessels that supply tumors.
It is often used in patients with relapsed or refractory NHL, particularly in combination with other therapies. Lenalidomide is taken orally as a daily pill.
Patients may experience tumor shrinkage and symptom relief, but side effects like fatigue and low blood cell counts can occur.
Procedures
Radiation Therapy: Radiation therapy uses high-energy beams to target and destroy cancer cells in specific areas of the body.
It is often used in early-stage NHL or to treat localized areas where the lymphoma is causing symptoms. Radiation can be used alone or in combination with chemotherapy.
Patients may experience symptom relief and tumor shrinkage within weeks of starting treatment, but side effects like fatigue and skin irritation are common.
Stem Cell Transplant: A stem cell transplant involves replacing damaged or destroyed bone marrow with healthy stem cells, which can help regenerate the immune system and fight cancer.
This procedure is typically reserved for patients with relapsed or refractory NHL who have not responded to other treatments. It can involve either autologous (using the patient’s own cells) or allogeneic (using donor cells) transplants.
Patients may experience long-term remission, but the procedure carries risks like infections and graft-versus-host disease.
CAR T-Cell Therapy: CAR T-cell therapy is an advanced treatment that involves modifying a patient’s own T-cells to better recognize and attack cancer cells.
This therapy is typically used in patients with aggressive or relapsed NHL who have not responded to other treatments. It is a highly specialized procedure available at select treatment centers.
Patients may experience significant tumor shrinkage and long-term remission, but side effects like cytokine release syndrome and neurological symptoms can occur.
Improving Non-Hodgkin Lymphoma and Seeking Medical Help
While medical treatments are essential for managing Non-Hodgkin lymphoma, home remedies and lifestyle changes can also improve overall well-being:
- Healthy Diet: A balanced diet rich in fruits, vegetables, and lean proteins can support your immune system and boost energy levels.
- Regular Exercise: Gentle physical activity, like walking or yoga, can reduce fatigue and improve mood.
- Stress Management: Techniques like meditation, deep breathing, and mindfulness can help reduce stress and enhance emotional well-being.
- Adequate Sleep: Getting enough rest is crucial for your body to heal and recover from treatments.
- Hydration: Drinking plenty of water helps flush toxins from your body and keeps you energized.
If you experience new or worsening symptoms, such as unexplained weight loss, night sweats, or persistent fatigue, seek medical help. Telemedicine offers a convenient way to consult with healthcare providers from the comfort of your home, allowing for timely intervention and personalized care.
Living with Non-Hodgkin Lymphoma: Tips for Better Quality of Life
Living with Non-Hodgkin lymphoma can be challenging, but there are steps you can take to improve your quality of life:
- Stay Informed: Understanding your diagnosis and treatment options can help you feel more in control of your health.
- Build a Support System: Lean on family, friends, and support groups to help you cope with the emotional and physical challenges of living with lymphoma.
- Manage Side Effects: Work closely with your healthcare team to manage side effects from treatment, such as fatigue, nausea, and pain.
- Focus on Mental Health: Consider speaking with a counselor or therapist to help manage anxiety, depression, or stress related to your diagnosis.
- Maintain a Routine: Keeping a regular schedule for meals, sleep, and activities can help you feel more grounded and in control.
Conclusion
Non-Hodgkin lymphoma is a complex and varied disease, but with early diagnosis and appropriate treatment, many patients can achieve remission and lead fulfilling lives. Treatment options range from chemotherapy and targeted therapies to advanced procedures like CAR T-cell therapy, offering hope for patients at all stages of the disease.
Early intervention is key to improving outcomes, so if you’re experiencing symptoms or have concerns about your health, don’t hesitate to reach out to a healthcare provider. Our telemedicine practice offers convenient, compassionate care, allowing you to consult with experts from the comfort of your home. Schedule an appointment today to take the first step toward better health.
