Wednesday, April 10, 2024

Non Hodgkin’s Lymphoma And Shingles

Collecting The Stem Cells

Herpes zoster ophthalmicus -1 (viral corneal ulcer)

Stem cells must first be collected in one of the following ways:

  • Directly from blood, called peripheral blood stem cell transplantation
  • From bone marrow, called BMT
  • From umbilical cords or placentas

PBSCT is the most commonly performed type of stem cell transplantation.

Donor or Patient Cells

The marrow or blood stem cells can be taken from the patient or from a matched donor :

  • In an autologous transplant, the marrow or blood cells used for replacement are taken from the patient. Autologous transplants are the most common type of transplant used for lymphoma. However, if the cancer has spread to the blood or bone marrow, there is some danger that these cells may contain tumor cells, and that the cancer can regrow.
  • In an allogeneic transplant, bone marrow or stem cells are taken from a donor. Siblings are the best donors. Only about 25% of transplants for NHL are the allogeneic type. Allogeneic transplants have increased risks for serious side effects and complications. Older people who cannot tolerate the preparatory treatment required for a standard allogeneic transplant may be able to receive a non-myeloablative transplant , which uses lower doses of chemotherapy and radiation.

The Blood Stem Cell Collection Procedure


Shingles Vaccine Shows Promise In Lymphoma Patients

  • Shingles Vaccine Shows Promise in Lymphoma Patients

Vaccines are often not effective in individuals with lymphoma, but a new study shows that it is possible for these patients to mount a potent immune response to the shingles vaccine.

Wilmot Cancer Institute researchers focused on this hard-to-vaccinate group and how best to prevent this particular illness because people with blood cancers are at higher risk of shingles and its complications, which can be fatal in this population. Shingles is a painful reactivation of the chicken pox virus. It is most common in older adults and can cause debilitating rashes and other health problems.

The shingles vaccine is standard care for everyone over age 50. In people with lymphoma, however, doctors have had two concerns about this vaccine in the past: That a weakened immune system due to B-cell blood cancer does not allow a person to make an effective immune response to the vaccine and that a common treatment for lymphoma, known as BTK inhibitors, might interrupt or prevent an immune response to the vaccine.

According to the Wilmot research published in the journal, Leukemia, 32 lymphoma patients who received a newer version of the shingles vaccine responded favorably. The new vaccine uses an inactivated virus and is safer for people with weakened immune systems.

Signs And Symptoms Of Non

Non-Hodgkin lymphoma can cause many different signs and symptoms, depending on the type of lymphoma and where it is in the body. Sometimes it might not cause any symptoms until it grows quite large.

Having one or more symptoms doesnt mean you definitely have lymphoma. In fact, many of the symptoms listed here are more likely to be caused by other conditions, such as an infection. Still, if you have any of these symptoms, have them checked by a doctor so that the cause can be found and treated, if needed.

Some common signs and symptoms include:

  • Enlarged lymph nodes
  • Feeling full after only a small amount of food
  • Chest pain or pressure
  • Shortness of breath or cough
  • Severe or frequent infections

Some people with Non-Hodgkin lymphoma have what are known as B symptoms:

  • Fever without an infection
  • Drenching night sweats
  • Weight loss without trying

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Moffitts Approach To Lymphoma Diagnosis And Treatment

If youre experiencing a skin rash, itchiness or any other symptoms associated with lymphoma, you can turn to Moffitt Cancer Center for a diagnosis and treatment. We take a multispecialty approach to cancer care, and our renowned Malignant Hematology Program includes board-certified surgeons and physicians, medical oncologists, radiation oncologists, radiologists, nurses, researchers and supportive care specialists who work closely together on behalf of our patients. Each week, our tumor board of cancer specialists meets to review complex cases and make any necessary treatment adjustments. Thanks to our collaborative approach, our patients receive the benefit of multiple expert opinions without the need for referrals.

To request an appointment at Moffitt Cancer Center, call us at or fill out our new patient registration form online. Something that sets us apart from other cancer treatment providers is our exceptionally quick turnaround timewe connect each new patient with a cancer expert within just one day, which is faster than any other cancer hospital across the nation.

Symptoms From Lymphoma Affecting The Brain


Lymphomas of the brain, called primary brain lymphomas, can cause headache, trouble thinking, weakness in parts of the body, personality changes, and sometimes seizures.

Other types of lymphoma can spread to the area around the brain and spinal cord. This can cause problems such as double vision, facial numbness, and trouble speaking.

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Other Hodgkin Lymphoma Symptoms

In addition to itchiness triggered by the release of cytokines, individuals with Hodgkin lymphoma may experience the following symptoms:

  • Lymph node swelling, particularly in the neck, armpits, stomach or groin
  • A low-grade fever accompanied by chills
  • Severe night sweats
  • Physical, mental or emotional exhaustion
  • Unexplained weight loss
  • Other issues specific to the location of the lymphoma, such as chest pain, difficulty breathing, or a feeling of being full

Immune System Deficiency Disorders

People with diseases or conditions that affect the immune system may be at higher risk for lymphomas:

  • HIV-positive patients and those with full-blown AIDS are at higher risk for NHL, and the disease is more likely to be widespread in these people than in those without it. Most AIDS-related NHLs are high-grade lymphomas.
  • People who have organ transplants are at higher risk for NHL, probably due to multiple factors, including the drugs used to suppress the immune system and the transplanted organ itself.
  • People who have had high-dose chemotherapy and stem-cell transplantation are at higher risk.

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How Can I Reduce My Risk Of Developing Non

There are several risk factors linked to non-Hodgkin lymphoma. A risk factor is an activity or physical condition that increases your risk of developing a certain disease. Your risk of developing a non-Hodgkin lymphoma increases if you’re:

Medical conditions

The following conditions may increase your risk:

  • Autoimmune diseases: People with inflammatory bowel disease, rheumatoid arthritis, psoriasis or other rheumatologic conditions may have an increased risk of developing a non-Hodgkin lymphoma.
  • HIV/AIDS: Human immunodeficiency virus is the virus that causes acquired immune deficiency syndrome . Having non-Hodgkin lymphoma doesnt mean you have HIV/AIDS.
  • Helicobacter pylori infection: This infection causes stomach ulcers. Repeated bouts of this infection increase your risk of developing a non-Hodgkin lymphoma.
  • Human T-lymphotrophic virus Type I or Epstein-Barr virus.

Medical treatments

Some people who have had the following treatments may develop a non-Hodgkin lymphoma:

  • Organ transplant: People whove gone through organ transplantation including heart, lung and kidney transplantations have increased risk of developing lymphoma. This is because they need to take anti-rejection medication that suppresses their immune systems.
  • Previous treatment for non-Hodgkin lymphoma.
  • Radiation therapy.

Other risk factors

You may develop a non-Hodgkin lymphoma if you:

Active Shingles Infection As Detected On 18f

What does multiple swollen lymph nodes of head & neck signify? – Dr. Ramakrishna Prasad
  • 1Division of Nuclear Medicine, Department of Radiology, Saint Louis University, St. Louis, MO, USA
  • 2Department of Hematology/Oncology, Saint Louis University, St. Louis, MO, USA
  • 3Division of Nuclear Medicine, Department of Radiology, St. Louis VA Medical Center, St. Louis, MO, USA

We present the case of a 56-year-old male with a history of recurrent follicular lymphoma undergoing chemotherapy with multiple 18F-FDG PET-CT studies at an outside facility. He developed a painful erythematous, pruritic rash in the left back requiring a visit to the emergency room. He was diagnosed and treated for Varicella zoster infection. He then presented to our imaging center 2 months later for a follow up 18F-FDG PET/CT study. Imaging demonstrated a cutaneous band of increased metabolic activity in the upper back following a dermatomal distribution. This was confirmed to be in the same area as the treated Varicella zoster eruption. A subsequent follow up 18F-FDG PET-CT scan 4 months later to confirm tumor resolution demonstrated the abnormal band of uptake in the back had resolved. This case illustrates the significance of being aware of this entity and to distinguish it from metastasis, especially in patients with a known history of malignancy.

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Inactivated Shingles Vaccine Now Available For People Who Cant Have Live Vaccines

An alternative to the live shingles vaccine is now available in the UK for people with lowered immunity.

This month, a shingles vaccine became available in the UK for people who cant have the live vaccine.Currently, shingles vaccination is recommended for people aged 70 to 79. However, until recently, the only vaccine available in the UK was based on a live but weakened version of varicella zoster virus . This is not suitable for people with low immune systems because it could cause shingles infection.From 1 September 2021, a vaccine called Shingrix® is available for people with lowered immunity. This contains a protein made by the varicella zoster virus but it does not contain the virus itself. It cannot cause shingles.People aged 70 to 79 who may be eligible for Shingrix® vaccine instead of the live vaccine include:

Side Effects And Complications

Side effects and complications of any chemotherapeutic regimen are common. They are more severe with higher doses. Side effects may increase over the course of treatment. Radiation treatment may worsen chemotherapy side effects.

Common Side Effects

Common side effects include:

  • Nausea and vomiting. Drugs known as serotonin antagonists, such as ondansetron or granisetron , can relieve these side effects.
  • Fatigue is very common after chemotherapy and may last for several years.
  • Bladder cancer is associated with certain types of chemotherapy drugs used for NHL.
  • Infertility is a risk, particularly with the use of cyclophosphamide.
  • Heart failure risk increases with regimens containing certain drugs, particularly doxorubicin or mitoxantrone.
  • Osteoporosis and increased risk for fracture may occur in people treated with steroid drugs such as prednisone.

In general, these serious late side effects depend on the type of drug used and cumulative drug dose.

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Diagnosing Stages Of Lymphoma

There are several diagnostic tests used to determine the lymphoma stage. Testing can also help determine how you’re responding to your current treatment for this disease. These tests vary, based on your symptoms.

Swollen or enlarged lymph nodes will be biopsied to confirm a diagnosis of Hodgkins or non-Hodgkins lymphoma. In many instances, the entire lymph node will be removed for laboratory testing. This ensures that enough tissue is available for analysis and diagnosis.

A bone marrow aspiration and biopsy will be done to determine if cancer has spread to the bones. Usually, the bone marrow is taken from the hip bone for this test.

A spinal tap to remove and test cerebrospinal fluid may be done if your doctor suspects that lymphoma has spread to the brain.

Sampling of pleural fluid or peritoneal fluid may be done to check for spread into the chest or stomach. Lymphoma can cause fluid buildup in these and other areas of the body. These tests use fluid extracted from the abdomen or chest to look for cancer cells.

Imaging tests will be done to identify enlarged lymph nodes and organs where cancer may have spread. They include:

  • Computed tomography scan: A cross-sectional detailed X-ray study
  • Ultrasound: Uses sound waves to produce images
  • Magnetic resonance imaging scan: Uses magnetic fields
  • Bone scan: Uses a radioactive tracer to look for bone damage and cancer
  • Positron-emission tomography scan: Uses radioactive sugar to identify highly active cells

Symptoms From Lymphoma In The Chest


When lymphoma starts in the thymus or lymph nodes in the chest, it may press on the nearby trachea , which can cause coughing, trouble breathing, or a feeling of chest pain or pressure.

The superior vena cava is the large vein that carries blood from the head and arms back to the heart. It passes near the thymus and lymph nodes inside the chest. Lymphomas in this area may push on the SVC, which can cause the blood to back up in the veins. This can lead to swelling in the head, arms, and upper chest. It can also cause trouble breathing and a change in consciousness if it affects the brain. This is called SVC syndrome. It can be life-threatening and must be treated right away.

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Whats It Like To Live With Non

For some people, living with non-Hodgkin lymphoma means their treatment eliminated the cancer cells and they’re cured. This is more common after treatment for aggressive lymphoma. Other people may have this condition for the rest of their lives. Its important to remember that with some forms of non-Hodgkin lymphoma, many people have normal quality of life. Its just as important to remember that not everyone who’s diagnosed ultimately dies from it, even if the condition cant be cured.

Living in remission

If your condition is in remission, it means treatment eliminated all signs and symptoms of non-Hodgkin lymphoma. Even so, youll need regular checkups so your healthcare provider can monitor your overall health and watch for relapse.

You may feel anxious because you cant be sure you wont get sick again. If thats your situation, talk to your provider. They may have information to make you worry less. They may also have resources to help you manage your emotions.

Living with a non-Hodgkin lymphoma

Some people with a non-Hodgkin lymphoma will need continuous treatment. Other people may need occasional treatment. In both cases, however, these people will still have a non-Hodgkin lymphoma and will need some form of treatment for the rest of their lives.

When Should I See My Healthcare Provider

If youre receiving treatment for non-Hodgkin lymphoma, you should contact your provider if your symptoms return or get worse.

When should I go to the emergency room?

You should go to the emergency room if you have treatment side effects that dont subside after taking prescribed medication, are stronger than you expect or continue for a long time.

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Do People Survive Non

Yes, people who have treatment for non-Hodgkin lymphomas go into remission. Remission means they dont have any symptoms and tests show they dont have signs of the condition. Some people are considered to be cured because theyve remained in remission for many years. Sometimes non-Hodgkin lymphomas come back. Studies show most aggressive non-Hodgkin lymphomas come back during the first two years after treatment, or they never come back.

Its important to remember that not everyone diagnosed with a non-Hodgkin lymphoma ultimately dies from it, even if the condition cant be cured.

What is the risk of relapse?

There are two reasons why your condition may come back:

  • Your treatment didnt eliminate the condition.
  • Your condition went into remission and then came back or relapsed. This may happen because treatment eliminated fast-growing cells but left slow-growing cells behind.

Can my healthcare provider estimate the chance my condition will come back?

Yes, they can. For example, if you have an aggressive type of non-Hodgkin lymphoma, your healthcare provider may use the International Prognostic Index , one of several risk-scoring tools. The index is based on factors such as your age, non-Hodgkin lymphoma stage and certain blood test results.

Stage 4 Lymphoma Prognosis

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Lymphoma is not a cookie-cutter disease. Many factors may have an impact on your potential prognosis. Your response to treatment, age, and overall health all play a role. The number of lymph node areas or organs affected may also have an impact.

The data used to compute the five-year relative survival rate for stage 4 lymphoma are based on the experiences of people who were diagnosed five or more years ago. Since treatments are always improving, this data may not take into account new treatments and, so, may not be able to predict what will happen in your case.

These numbers are based on data maintained by the National Cancer Institute’s Surveillance, Epidemiology, and End Results database:

  • Stage 4 non-Hodgkin’s diffuse large B-cell lymphoma has a five-year relative survival rate of 57%
  • Stage 4 non-Hodgkin’s follicular lymphoma has a five-year relative survival rate of 86%
  • Stage 4 Hodgkin’s lymphoma has a five-year relative survival rate of 82%

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What Are The 5

Doctors often use 5-year survival rates to estimate the chances of survival from a cancer. For example, a 5-year survival rate of 70 percent means 70 percent of people with a certain cancer are expected to be alive 5 years later.

Relative 5-year overall survival rate is also commonly used. A relative 5-year survival rate compares the number of people still alive with a certain cancer to the number people without the cancer to isolate deaths directly caused by the disease.

For example, a relative 5-year overall survival rate of 70 percent means a person with a certain cancer has a 70 percent chance of being alive 5 years later compared with a person without the cancer.

Survival rates are sometimes reported for other intervals, such as 1, 3, 10, and 15 years.

National Health Insurance Research Database

The data for this study were from the National Health Insurance Research Database , which is derived from the National Health Insurance of Taiwan and has been which was implemented since March 1st of 1995. This nationwide population-based database provided the most comprehensive information for this study.

For patients with certain severe illnesses, such as autoimmune diseases, end-stage renal disease and malignant diseases, the NHI has established a registration system . The patients who met the criteria for catastrophic illness are registered, and their responsibilities for all co-payments are waived. For patients with NHL, certificates of catastrophic illness are issued when the lymphoma pathologically proven.

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