Lymphoma, the most common type of blood cancer, occurs when white blood cells called lymphocytes reproduce and grow excessively.
The disease can develop in any part of the body. Most commonly the initial site is the lymph nodes, which are crucial parts of the lymphatic and immune system. There are numerous sub-types of lymphomas which are classified according to characteristics, location, or extent.
Lymphoma can be either Hodgkin’s or the more common non-Hodgkin’s. Lymphomas also differ by the cells from which it originates, either B-cells or T-cells; proteins present on the surface of the lymphoma cells; and the genetic mutations that occur in the cells.
Two grades of non-Hodgkin lymphoma exist: high grade lymphoma which grows quickly, and low grade lymphoma which grows slowly.
Low Grade Lymphoma Development and Risk Factors
Low grade lymphoma, also known as indolent lymphoma, is usually very slow growing and most often incurable, though many patients respond positively to treatment. Low grade lymphomas can be localized in the initial stages, or in severe cases it can spread to different sites. The patient’s treatment choices and quality of life are largely determined by the disease growth and spread.
Types of low grade lymphoma include: follicular lymphoma, mantle cell lymphoma, marginal zone lymphoma, extranodal marginal zone lymphoma, nodal marginal zone lymphoma, splenic marginal zone lymphoma, small lymphocytic lymphoma, lymphoplasmacytic lymphomas, and skin lymphomas.
About 40% of non-Hodgkin lymphoma are classified as low grade. It is more common among older patients and affects men and women almost equally.
Low Grade Lymphoma Symptoms and Diagnosis
Patients with low grade lymphoma usually experience little to no symptoms. The first signs of the disease include swollen but painless lymph nodes. Fever, night sweats, unexplained weight loss, fatigue, bone, abdominal or chest pain, loss of appetite, itching and nausea occur in time.
Because many symptoms can be explained by other illnesses, an early diagnosis can be difficult.
Diagnosis begins when the physician performs a complete physical examination and requests a personal medical and family history. A biopsy to analyze the damaged tissue is usually the next stop. Other tests can include chest, abdomen and pelvis or other computed tomographic (CT) imaging, a chest x-ray, a positron emission tomography (PET) scan, spinal fluid exam, and blood tests to evaluate the type, stage and extent of the lymphoma.
Prevalence and Treatment of Low Grade Lymphoma
Approximately one in every five patients are diagnosed with low grade non-Hodgkin lymphoma in early stages when the disease is localized and the prognosis is encouraging. During the initial phases, the disease is typically limited to one or two groups of lymph nodes and the physician may decide to watch for while. Radiotherapy, an initial stage option, is designed to slow the cancer growth even more.
In cases of advanced low grade non-Hodgkin’s lymphoma, prospects are not so positive, but not completely hopeless. Treatment aims to control the lymphoma and physician may recommend drug therapies. Some therapies include a monoclonal antibody called rituximab, either alone or with a single chemotherapy drug like bendamustine or fludarabine; or a combination of drugs like CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone).
In more severe cases, monoclonal antibodies ibritumomab and tositumomab is administered as second-line therapy.