Lymphoma is cancer that begins in cells of the lymph system. The lymph system is part of the immune system, which helps the body fight infection and disease. The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Lymphomas are types of cancer derived from lymphocytes, a type of white blood cell. Lymphomas are treated by combinations of chemotherapy, monoclonal antibodies (CD20), immunotherapy, radiation, and hematopoietic stem cell transplantation. Non-Hodgkin lymphoma (NHL) are among the six most common cancer types in Switzerland with a stable standardized incidence rate for NHL at about 17 yearly diagnoses in males or 12 in females per 100’000 for the last 20 years. Standardized mortality rates decreased from 7 deaths due to NHL to 5 per 100’000 in males and from 5 to 3 per 100’000 in females in the same time period.
Many new chemotherapy drugs are being studied in clinical trials. In recent years, these studies have led to the approval of drugs such as bendamustine (Treanda) and pralatrexate (Folotyn) for use against certain types of lymphoma. Other studies are looking at new ways to combine drugs using different doses or different sequences of drugs. While some patients with non-Hodgkin's lymphoma can be successfully treated, for many the most-effective course is to keep knocking back the disease over a period of many years. In these cases, personalized long-term care is especially important. Laboratory studies in a patient with suspected NHL should include the following:
•Immunophenotypic analysis of lymph node, bone marrow, peripheral blood
•Cytogenetic studies: NHL occasionally associated with monoclonal gammopathy; possible positive Coombs test; maybe hypogammaglobulinemia