AIDS-related lymphoma is a disease in which cancer (malignant) cells are found in the lymph system in patients who have AIDS (acquired immunodeficiency syndrome).AIDS is caused by the human immunodeficiency virus (HIV), which attacks and weakens the immune system. Infections and other diseases can then invade the body, and the immune system cannot fight against them.
The lymph system is made up of the following: -
- Lymph: - Colorless, watery fluid that travels through the lymph system and carries white blood cells called lymphocytes. Lymphocytes protect the body against infections and the growth of tumors.
- Lymph vessels: - A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.
- Lymph nodes: - Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.
- Spleen: - An organ that makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. The spleen is on the left side of the abdomen near the stomach.
- Thymus: - An organ in which lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.
- Tonsils: - Two small masses of lymph tissue at the back of the throat. The tonsils make lymphocytes.
- Bone marrow: - The soft, spongy tissue in the center of large bones. Bone marrow makes white blood cells, red blood cells, and platelets.
There are many different types of lymphoma.
Lymphomas are divided into two general types: -
Hodgkin lymphoma and non-Hodgkin lymphoma. Both Hodgkin lymphoma and non-Hodgkin lymphoma may occur in AIDS patients, but non-Hodgkin lymphoma is more common. When a person with AIDS has non-Hodgkin lymphoma, it is called an AIDS-related lymphoma.
Non-Hodgkin lymphomas are grouped by the way their cells look under a microscope. They may be indolent (slow-growing) or aggressive (fast-growing). AIDS-related lymphoma is usually aggressive.
There are three main types of AIDS-related lymphoma: -
- Diffuse large B-cell lymphoma
- B-cell immunoblastic lymphoma
- Small non- cleaved cell lymphoma
Signs and SymptomsA doctor should be seen if any of the following symptoms persist for longer than 2 weeks: painless swelling in the lymph nodes in the neck, underarm, or groin; fever; night sweats; tiredness; weight loss without dieting; or itchy skin.
DiagnosisIf a patient has AIDS and symptoms of lymphoma, a doctor will carefully check for swelling or lumps in the neck, underarms and groin. If the lymph nodes do not feel normal, the doctor may need to cut out a small piece of tissue and look at it under the microscope to see if there are any cancer cells. This procedure is called a biopsy.
In general, lymphomas are classified by (1) how rapidly they grow; (2) how cureable they are and (3) similarities in overall survival and disease free survival.
In general, patients with AIDS-related lymphoma respond to treatment differently from patients with lymphoma who do not have AIDS. AIDS-related lymphoma usually grows faster and spreads outside the lymph nodes and to other parts of the body more often than lymphoma that is not related to AIDS. Because therapy can damage weak immune systems even further, patients who have AIDS-related lymphoma are generally treated with lower doses of drugs than patients who do not have AIDS.
TreatmentThe treatment of AIDS-related lymphoma is difficult because of the problems caused by HIV infection, which weakens the immune system. The drug doses used are often lower than drug doses given to patients who do not have AIDS. Two types of treatment are used:
- chemotherapy (using drugs to kill cancer cells and shrink tumors)
- radiation therapy(using high-dose x-rays or other high-energy rays to kill cancer cells and shrink tumors)
Chemotherapy is the use of drugs to kill cancer cells and shrink tumors. Chemotherapy may be taken by pill, or it may be put into the body by inserting a needle into a vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body. Chemotherapy may be put into the fluid that surrounds the brain through a needle in the brain or back (intrathecal chemotherapy) to treat non-Hodgkin's lymphoma that has spread to the brain.
Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation for non-Hodgkin's lymphoma usually comes from a machine outside the body (external-beam radiation therapy). Radiation given to the brain is called cranial irradiation. Radiation therapy may be used alone or in addition to chemotherapy.
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