"The highest incidence of follicular lymphoma occurs mainly in older people. This is a reason to investigate a treatment that enhances the effectiveness of conventional therapies and does not increase their toxicity".
DR. JOSÉ RIFÓN
SPECIALIST. HAEMATOLOGY AND HAEMOTHERAPY DEPARTMENT
Lymphoma is characterized by the malignant proliferation of lymphocytes that constitute the defensive cells of the immune system.
Lymphoid tissue is mainly found in the lymph nodes, so lymphomas are generally characterized by the presence of enlarged lymph nodes.
However, there are also lymphoid cells in many other organs, so lymphomas can affect the digestive tract, spleen, liver, lung, bone marrow, etc.
The incidence of this pathology is high, since every year 5,000 new cases are diagnosed in Spain in adults over 40 years old.
The multidisciplinary coordination allows the study and diagnosis in a short time. In addition, the Clinica Universidad de Navarra has the most advanced techniques for the diagnosis of the disease.
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What are the symptoms of lymphoma?
In general, lymphomas present themselves as enlarged lymph nodes, which when they appear in accessible areas such as the neck, armpits or groin can be palpated showing their size.
However, not all enlarged nodes have their origin in a lymphoma. There are various infections and other diseases that cause an increase in lymph nodes. For this reason, it is important to go to the specialist and, if in doubt, perform a biopsy.
Sometimes, the affected nodes are very internal (abdomen, mediastinum...) and can go unnoticed, so the diagnosis is more difficult and is only achieved when other symptoms appear (fever, night sweats, tiredness, significant weight loss, itching...), which require more exhaustive studies.
Learn all about lymphomas and their treatment options (available in spanish)
The most common symptoms are:
- Night sweats.
- Loss of weight.
- Palpation of adenopathies.
Do you have any of these symptoms?
You may have lymphoma
What are the causes of lymphoma?
The cause of lymphomas is currently unknown. They account for 84% of all neoplastic hematological diseases.
However, it has been found that Hodgkin's lymphoma is more common among people from 15 to 35 and from 50 to 70 years old. One of the reasons why this lymphoma could appear could be associated with a past infection with the Epstein-Barr virus (EBV).
On the other hand, HIV-infected patients are at greater risk for the disease than the general population.
Non-Hodgkin's lymphomas, although they can appear at any age, have an incidence of less than 5% in children. Most subtypes increase in frequency with age, with the average age of onset being 65 years. It is somewhat more frequent in males and the causes are unknown.
What is the prognosis of lymphomas?
It is very important to make an accurate diagnosis, as well as a good study of the extent of the disease, which will allow us to have all the necessary data to decide the most appropriate treatment.
Traditionally, lymphomas have been divided into:
- Aggressive or with a high degree of malignancy, when the malignant cells grow more rapidly. They are more serious and need stronger treatments, but are potentially curable.
- Indolent or low grade malignant lymphomas, when the cells are slower growing. They allow a better quality of life for years but are very difficult to cure definitively.
At present, there is a tendency to establish a differentiated prognosis in each case, taking into account the variety of lymphoma, its extension and the therapeutic possibilities in each specific patient.
Lymphomas are one of the tumors whose incidence is increasing, especially that of non-Hodkin's lymphomas, although it is not known what the causes of this increase are.
However, they are also among the tumors with the most therapeutic options and, taking into account their diversity, among those with the greatest possibilities of cure at present.
How is lymphoma diagnosed?
We offer a multidisciplinary approach to the diagnosis and prognosis of the disease. In the effectiveness of the treatment, the global therapeutic consideration of the disease plays a fundamental role, that is, not only the treatment that each patient will need at the moment of diagnosis, but also the treatment that may be required in the future in case of possible relapses.
The Hematology Department of the Clinic has developed a comprehensive program of care for patients with chronic lymphoproliferative syndromes, which includes all aspects related to the diagnosis, prognosis and treatment of the disease.
This program has been developed in collaboration with other services and departments, which allows the study to be carried out on an outpatient basis.
The Unit of Genomic Medicine of the Clinic, the laboratory of cytogenetics and molecular genetics have specialized in the study of the chromosomal alterations characteristic of each lymphoma, which allows a better identification of the disease and the determination of the prognosis of a patient, which many times will condition the most suitable treatment.
How is lymphoma treated?
We have a Day Hospital for outpatient treatment of lymphomas
The specific treatment of the disease is based on the use of chemotherapy in most cases administered on an outpatient basis at the Day Hospital, which allows for prolonged treatments without the need for hospitalization, with the consequent comfort for the patient and a reduction in the economic cost.
Sometimes it is necessary to resort to Hematopoietic Progenitor Transplant.
In this sense, the Clinic has a transplant program, both autologous and allogeneic, including reduced intensity transplants. Some patients are subject to treatment with radiotherapy.
The departments of Radiotherapy Oncology and Oncology of the Clinic have the necessary linear accelerators to carry out this type of treatments.
Its goal is to achieve the restoration of bone marrow function cells.
Hematopoietic progenitor transplantation or marrow transplantation is used in:
- Neoplastic diseases (malignant tumors).
- Diseases with an alteration of the function of the bone marrow (producer of blood cells).
- Diseases of the immune system.
- In some congenital metabolic alterations.
- Hemopoietic progenitor cells were obtained from the bone marrow. Currently, they are mostly extracted from the blood and sometimes from the umbilical cord and the placenta.
These cells are found inside the bone marrow of bones (especially hips, vertebrae and ribs), but sometimes their number increases in the circulating blood, so they can also be obtained through the veins.
One of the treatments that have revolutionized the therapy of lymphoproliferative syndromes has been the application of monoclonal antibodies.
With them, it has been possible to increase in a significant percentage the rate of answers that were obtained only with the chemotherapy.
The most used is the anti-CD20 antibody, which binds to lymphoid cells and induces their destruction. To date, at the Clinic, this treatment has been administered together with chemotherapy to almost 700 patients, mainly follicular lymphomas and large cell lymphomas.
Recently, in coordination with the Nuclear Medicine Service, the use of other types of monoclonal antibodies has been initiated, which combine the effectiveness of the previously described with the action of a radioactive isotope to which they are attached.
In addition to treatments with conventional schemes, there is a line of clinical and therapeutic research in lymphoproliferative syndromes that mainly includes the use of new drugs and the development of specific immunotherapy against lymphoma
In relation to the use of new drugs, it is very possible that if you come to our center for treatment we will propose you to participate in one of the clinical trials in which we are offering new therapies to patients with lymphoma.
In this sense, the close collaboration between the physicians involved in the Program of lymphoproliferative syndromes and the Central Unit of Clinical Trials allows us to find therapeutic options even for some patients in whom the standard treatments with chemotherapy and/or radiotherapy have not worked.
What clinical trials do we have on Lymphomas?
A multidisciplinary team of renowned prestige being at the forefront
AT THE FOREFRONT
Advanced Therapy Unit
The Advanced Therapies Unit of Clínica Universidad de Navarra has been established in order to deal exclusively with cellular therapies against cancer and other diseases of the immune system, favouring their administration and seeking to increase the safety of these treatments.
A multidisciplinary team of highly specialised nurses together with physicians from all the specialities involved in the approach to those treatments that depend on advanced therapy drugs and immunotherapy
Where do we treat it?
IN NAVARRE AND MADRID
The Hematology and Hemotherapy Service of the
at the Clínica Universidad de Navarra
The Hematology Service of the Clinic, formed by specialists of recognized national and international prestige, has integrated molecular diagnostic techniques and the use of new personalized treatments in its assistance work, allowing a more precise and fast diagnosis of the hematological diseases.
The joint work of the medical staff and the researcher facilitates the development and application of the new treatments and at the same time the precise evaluation of the result of the treatments.
Why at the Clinica?
- Experts in the development of Cellular Therapy treatments.
- International reference center in lymphomas, multiple myeloma and monoclonal gammopathies.
- Experts in the diagnosis and treatment of hemorrhagic and thrombotic problems.