Lymphomas are a surprisingly diverse group of cancers that arise from cells of the immune system called lymphocytes, which are a type of white blood cell. Lymphomas can be categorized as non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL).
HL has a high cure rate of about 75% overall and up to 90% in young patients. The average 5-year relative survival rate for NHL is about 71%.
For those undergoing active treatment, integrative therapies such as selenium, green tea, and mistletoe extract may improve outcome.
Causes and Risk Factors
- Immunosuppression is the most well-established risk factor:
- Autoimmune disease
- Immunodeficiency syndromes
- HIV infection
- Organ or stem cell transplantation
- Male gender
- Older age
- Diets high in trans-fatty acids, processed meats, and high-fat dairy products were associated with increased NHL risk. Diets high in omega-3 fatty acids and fresh fish and seafood have been associated with reduced NHL risk. A high intake of vegetables lowers the risk of lymphoma by 30%.
- Men who drink ≥1 serving of soda daily, whether diet or regular (sugar-sweetened) soda, have an increased risk of NHL.
Signs and Symptoms include:
- Lymphadenopathy (swelling of the lymph nodes)
- Unexplained fever
- Night sweats
- Weight loss
Diagnosis of lymphoma may involve a number of clinical and laboratory tests, including:
- Medical history
- Physical examination
- Imaging studies
- Tissue biopsy
- Blood tests such as complete blood count (CBC), chemistry panel, and erythrocyte sedimentation rate (ESR)
- Laboratory techniques such as immunohistochemistry
- Assessment for infection
Conventional Treatment includes:
- Hodgkin Lymphoma:
- HL is treated typically with radiation and chemotherapy.
- Non-Hodgkin Lymphoma:
- Treatment options for NHL patients range from a "watch and wait" strategy to hematopoietic stem cell transplantation.
- Rituximab is often administered in conjunction with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). The combination of all 5 agents is referred to as “R-CHOP.”
Novel and Emerging Strategies include:
- Interleukin (IL)-6 inhibitors: Plasma IL-6 levels are significantly lower in patients whose lymphomas are in complete remission as compared to those in partial remission or those having progressive disease.
- Regular use of aspirin was associated with a considerably reduced risk of HL. Acetaminophen use was actually linked to an increased risk of the disease.
- In combination with rituximab, pixantrone has been shown to be superior to other single-agent therapies for the treatment of relapsed/refractory aggressive NHL.
Integrative Interventions include:
- Caloric restriction. An experiment in mice that develop cancers resembling Burkitt’s lymphoma and a form of NHL found that a reduced calorie diet (75% of normal intake) combined with a targeted therapy decreased the number of circulating lymphoma cells.
- Selenium. One clinical study reported that in patients with newly diagnosed NHL, 200 mcg/kg/day of sodium selenite significantly increased overall survival time. The selenium-supplemented patients had a significant reduction in swollen lymph nodes, decrease in spleen size and bone marrow infiltration, and a significant increase in lymphoma cell death.
- Green tea. Physicians at Mayo Clinic discovered that four patients with low-grade lymphomas began consuming over-the-counter green tea products containing epigallocatechin gallate (EGCG) on their own initiative. Subsequently, three of the four patients with low-grade B-cell lymphomas who used EGCG fulfilled the criteria for partial response.
- Curcumin. Preclinical studies report that curcumin is a radiosensitizer and chemosensitizer for lymphoma, making chemotherapy and radiation therapy work better against the cancer while protecting normal, healthy cells.
- Mistletoe extract. Clinical results showed that half of B-cell lymphoma patients receiving long-term mistletoe treatment had a continuous complete remission, whereas only 2/15 patients in the short-term mistletoe treatment group had a complete remission. The doses of mistletoe extract varied from 5–30 mg per subcutaneous injection.