T-cell lymphoma is a type of non-Hodgkin lymphoma that develops from T cells, a type of white blood cell important for immune function. In this article, we will take an overview look at T-cell lymphoma - its causes, symptoms, diagnosis and treatment options.
What are T Cells?
T cells, also known as T lymphocytes, are an essential part of the immune system. They help the body fight infections and diseases. There are two main types of T cells - CD4+ T cells (helper T cells) and CD8+ T cells (cytotoxic T cells). CD4+ T cells help coordinate the immune response by triggering other immune cells like B cells and macrophages. CD8+ T cells directly attack and destroy infected or cancerous cells.
Causes of T-cell Lymphoma
While the exact cause of T-cell lymphoma is unknown, factors that may increase the risk include:
- Weakened Immune System: Conditions like HIV/AIDS that weaken the immune system raise the risk as they disrupt the body's ability to regulate healthy T cell growth and division.
- Viral Infections: Viruses like Epstein-Barr virus (EBV) and human T-lymphotropic virus type 1 (HTLV-1) have been linked to increased risk of certain T-cell lymphomas like nasal NK/T-cell lymphoma and adult T-cell leukemia/lymphoma.
- Immunosuppressant Drugs: Medications taken after organ transplantation to prevent rejection of transplanted organs may potentially increase lymphoma risk by suppressing the immune system.
- Family History: Having a relative with T-cell or another type of lymphoma may increase one's own risk, suggesting a possible genetic component. However, most cases of T-cell lymphoma are not hereditary.
Symptoms of T-cell Lymphoma
The symptoms of T-cell lymphoma depend on the specific type and the stage of the disease. In the early stages, patients may experience:
- Swollen Lymph Nodes: Enlarged, often painless lumps in the neck, armpits or groin.
- Fatigue: Feeling tired or weak.
- Fever: Unexplained high temperature without any other cause.
- Night Sweats: Sweating episodes that soak clothing or sheets, especially at night.
- Weight Loss: Loss of appetite and unintentional loss of more than 10% of body weight over 6 months.
As the disease progresses, other symptoms may include cough, chest pain, difficulty breathing and neurological problems due to spread to other organs like the lungs, liver or brain.
Diagnosis of T-cell Lymphoma
If a patient is experiencing concerning symptoms, doctors will conduct tests to evaluate and diagnose T-cell lymphoma:
- Physical Exam and Medical History: Checking swollen lymph nodes and other signs.
- Blood Tests: Checking complete blood count and signs of infection/anemia.
- Biopsy of Lymph Node or Suspicious Tissue: Examining cells under microscope to identify malignant T cells.
- Bone Marrow Biopsy: Checking bone marrow for spreading cancer cells.
- Imaging Tests: X-rays, CT/PET scans to check size/location of lymph nodes and organs involved.
- Flow Cytometry: Examining cell surface markers to classify specific T-cell type involved.
Staging helps determine prognosis and is based on results of various tests regarding extent of cancer spread.
Treatment Options for T-cell Lymphoma
Treatment depends on the exact T-Cell Lymphoma subtype, stage of disease and patient health factors. Main options include:
- Chemotherapy: Using drug combinations to destroy cancer cells. CHOP is common for aggressive subtypes.
- Stem Cell Transplant: High-dose chemotherapy followed by infusion of healthy stem cells to reboot the immune system.
- Radiation Therapy: Using X-rays to damage and destroy cancer cells. Usually localized for early stages.
- Immunotherapy: Drugs like monoclonal antibodies that boost the immune system against lymphoma cells.
- Targeted Therapy: Newer drugs attacking specific molecular pathways driving cancer growth.
- Watchful Waiting: Certain indolent subtypes may not require immediate treatment if stable.
Prognosis varies but has improved thanks to more effective treatments. Ongoing clinical trials are investigating new treatment approaches for harder-to-treat T-cell lymphomas.
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