Book contents
- Frontmatter
- Contents
- List of contributors
- Preface to the first edition
- Preface to the second edition
- Acknowledgements
- Abbreviations
- 1 Practical issues in the use of systemic anti-cancer therapy drugs
- 2 Biological treatments in cancer
- 3 Hormones in cancer
- 4 Pathology in cancer
- 5 Radiotherapy planning 1: fundamentals of external beam and brachytherapy
- 6 Radiotherapy planning 2: advanced external beam radiotherapy techniques
- 7 Research in cancer
- 8 Acute oncology 1: oncological emergencies
- 9 Acute oncology 2: cancer of unknown primary
- 10 Palliative|care
- 11 Management of cancer of the head and neck
- 12 Management of cancer of the oesophagus
- 13 Management of cancer of the stomach
- 14 Management of cancer of the liver, gallbladder and biliary tract
- 15 Management of cancer of the exocrine pancreas
- 16 Management of cancer of the colon and rectum
- 17 Management of cancer of the anus
- 18 Management of gastrointestinal stromal tumours
- 19 Management of cancer of the breast
- 20 Management of cancer of the kidney
- 21 Management of cancer of the bladder
- 22 Management of cancer of the prostate
- 23 Management of cancer of the testis
- 24 Management of cancer of the penis
- 25 Management of cancer of the ovary
- 26 Management of cancer of the body of the uterus
- 27 Management of cancer of the cervix
- 28 Management of cancer of the vagina
- 29 Management of cancer of the vulva
- 30 Management of gestational trophoblast tumours
- 31 Management of cancer of the lung
- 32 Management of mesothelioma
- 33 Management of soft tissue and bone tumours in adults
- 34 Management of the lymphomas and myeloma
- 35 Management of cancers of the central nervous system
- 36 Management of skin cancer other than melanoma
- 37 Management of melanoma
- 38 Management of cancer of the thyroid
- 39 Management of neuroendocrine tumours
- 40 Management of cancer in children
- Multiple choice questions
- Multiple choice answers
- Index
- References
34 - Management of the lymphomas and myeloma
Published online by Cambridge University Press: 05 November 2015
- Frontmatter
- Contents
- List of contributors
- Preface to the first edition
- Preface to the second edition
- Acknowledgements
- Abbreviations
- 1 Practical issues in the use of systemic anti-cancer therapy drugs
- 2 Biological treatments in cancer
- 3 Hormones in cancer
- 4 Pathology in cancer
- 5 Radiotherapy planning 1: fundamentals of external beam and brachytherapy
- 6 Radiotherapy planning 2: advanced external beam radiotherapy techniques
- 7 Research in cancer
- 8 Acute oncology 1: oncological emergencies
- 9 Acute oncology 2: cancer of unknown primary
- 10 Palliative|care
- 11 Management of cancer of the head and neck
- 12 Management of cancer of the oesophagus
- 13 Management of cancer of the stomach
- 14 Management of cancer of the liver, gallbladder and biliary tract
- 15 Management of cancer of the exocrine pancreas
- 16 Management of cancer of the colon and rectum
- 17 Management of cancer of the anus
- 18 Management of gastrointestinal stromal tumours
- 19 Management of cancer of the breast
- 20 Management of cancer of the kidney
- 21 Management of cancer of the bladder
- 22 Management of cancer of the prostate
- 23 Management of cancer of the testis
- 24 Management of cancer of the penis
- 25 Management of cancer of the ovary
- 26 Management of cancer of the body of the uterus
- 27 Management of cancer of the cervix
- 28 Management of cancer of the vagina
- 29 Management of cancer of the vulva
- 30 Management of gestational trophoblast tumours
- 31 Management of cancer of the lung
- 32 Management of mesothelioma
- 33 Management of soft tissue and bone tumours in adults
- 34 Management of the lymphomas and myeloma
- 35 Management of cancers of the central nervous system
- 36 Management of skin cancer other than melanoma
- 37 Management of melanoma
- 38 Management of cancer of the thyroid
- 39 Management of neuroendocrine tumours
- 40 Management of cancer in children
- Multiple choice questions
- Multiple choice answers
- Index
- References
Summary
Introduction
The incidence of lymphoma is rising, and current attention is focused not just on improving cure rates, but also on minimising late effects of treatment. Patients should be managed by multidisciplinary teams that bring together the appropriate expertise of haematologists, oncologists, radiologists, pathologists and specialist nurses. Management guidelines are produced by the British Committee for Standards in Haematology (BCSH) and are a useful resource.
Lymphomas
Introduction
The World Health Organisation (WHO) classification of neoplasms of the hematopoietic and lymphoid tissues was first published in 2001 and updated in 2008 (Table 34.1: Swerdlow et al., 2008). This distinguishes more than 60 specific entities on the basis of morphologic, immunophenotypic, genetic, molecular and clinical features, stratified according to cell lineage and derivation from precursor or mature lymphoid cells.
Non-Hodgkin lymphoma (NHL) is the sixth most common cancer in the UK, with over 12,000 patients diagnosed each year, accounting for 4% of all new cases of cancer. The incidence is related to age, with the majority of cases diagnosed over the age of 65 years. Nearly half of all cases diagnosed in the UK are diffuse large B cell lymphoma (DLBCL, 48%). Marginal zone lymphomas (MZL) and follicular lymphoma (FL) account for 20% and 19%, respectively, with T cell lymphomas (6%), mantle cell lymphoma (MCL, 5%) and Burkitt lymphoma (2%) making up the remainder. Crude incidence rates in the UK range from 0.2 to 9 cases per 100,000.
Hodgkin lymphoma (HL) accounts for 0.6% of all cancer cases, with a relatively stable incidence of around 1700 cases per year. In children under 14 years of age, lymphoma is the third most common cancer after leukaemia and brain tumours. Lymphomas are the most common cancer in teenagers and young adults, accounting for 21% of cancers in this age group, with two-thirds of these being HL.
Aetiology
The aetiology of lymphoma is not clearly understood and appears to be multifactorial. The most significant risk factor is immune dysfunction which may be secondary to viral infection (e.g. HIV, HBV, HCV, EBV, HTLV-1), autoimmune disease or iatrogenic immunosuppression (Roman and Smith, 2011). Mucosa-associated lymphoid tissue (MALT) lymphomas are associated with antigenic stimulation by infectious agents including Helicobacter pylori, Chlamydia psittaci and Borrelia burgdorferi.
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- Information
- Practical Clinical Oncology , pp. 450 - 472Publisher: Cambridge University PressPrint publication year: 2015