What are the Different Types ... Video Transcript

Participants

, Maryann Bird , John D. Hainsworth MD

Summary

Non-Hodgkin's lymphoma is a complex -- and often confusing -- group of diseases. Tune in for an expert overview of the biology of NHL, as well as its diagnosis and treatment.

Webcast Transcript

MARYANN BIRD: Welcome to our webcast. I'm Maryann Bird. Non-Hodgkin's lymphoma -- or NHL -- is a complex disease. To begin with, there are thirty different types of NHL, making an accurate diagnosis both challenging and critical.

Joining me to discuss the ins and outs of NHL and its treatment is Dr. John Hainsworth of the Sarah Cannon Cancer Center here in Nashville. Dr. Hainsworth, thank you for joining us.

What is NHL and how does non-Hodgkin's lymphoma differ from Hodgkin's lymphoma?

JOHN D. HAINSWORTH, MD: NHL -- or non-Hodgkin's lymphoma -- is actually not one disease, but a family of diseases that are all types of lymphomas. Hodgkin's lymphoma -- or Hodgkin's disease -- is also a type of lymphoma, and actually that was one of the first ones described. It was then found that, actually, there are different ones that originate from different lymphocytes, have different ways that they act clinically, so all the ones that -- except for Hodgkin's disease are lumped into this category of non-Hodgkin's lymphoma.

MARYANN BIRD: What are the most common subtypes of NHL?

JOHN D. HAINSWORTH, MD: There are two types that are probably the most common -- and these two types are very different in the way they act. One is a group of lymphomas called the "follicular" lymphomas. They are generally low-grade lymphomas, and then another type called "large-cell" lymphomas. They look different under the microscope, they act different, and the large-cell lymphomas are very aggressive. So without treatment, patients would do very poorly with those, and actually those are fatal within a number of months in most patients.

MARYANN BIRD: What is the difference between lymphomas and leukemias?

JOHN D. HAINSWORTH, MD: In general, leukemias involve mostly the blood and the bone marrow. Lymphomas are much more likely to involve lymph nodes, other organs, and sometimes also the bone marrow.

MARYANN BIRD: Are there specific risk factors?

JOHN D. HAINSWORTH, MD: The risk factors for lymphomas are a number of other diseases that affect the immune system. Patients who have immune suppression because they have transplants, autoimmune diseases likes rheumatoid arthritis, lupus -- HIV infection has been a common one recently that's lead to a rise in lymphoma incidence.

MARYANN BIRD: What are the signs and symptoms of NHL? Do they differ from the symptoms of other blood cancers?

JOHN D. HAINSWORTH, MD: I think this is a hard question to answer, because of the different kinds of lymphoma, so there's a wide variation.

In general, for the low-grade lymphomas, usually just finding some lymph nodes enlarged. Other symptoms are very much more common, though, in patients who have aggressive lymphomas and they usually feel bad. They often have fatigue, weight loss, fevers, night sweats, a variety of other things. And then local symptoms depending on where the lymphoma's involving.

MARYANN BIRD: How is NHL diagnosed?

JOHN D. HAINSWORTH, MD: The actual diagnosis is based on a biopsy of some kind. This is actually one of the diseases that most challenging for pathologists. It's fairly easy to say, "This is a lymphoma." But sometimes it's not so easy to put it into a category. That's a very important for treatment.

MARYANN BIRD: And that leads me to the next question. Can NHL be cured?

JOHN D. HAINSWORTH, MD: And again, that's -- it's different diseases, so some of them -- the answer to that question is yes. In fact, some of the subtypes of aggressive lymphoma and large-cell lymphoma, the cure rate's pretty high. Others the answer is no.