Follicular lymphoma: symptoms, causes, treatment. The period of remission and relapse of follicular lymphoma

Lymphoma is a disease in which lymphatic tissue is affected . In this case, the affected lymphocytes begin to intensively divide and provoke failures in the normal operation of the internal organs of the human body. Isolate groups of the disease: lymphogranulomatosis (or so-called Hodgkin's disease) and non-Hodgkin's lymphomas (including follicular non-Hodgkin's lymphoma).

Lymphatic system. What it is

Part of the immune system of our body is the lymphatic, the main function of which is protection against all kinds of infections and other diseases. It is a network of channels through which a special liquid moves - lymph. In the course of the capillaries, lymph nodes are observed, in which lymph is enriched by special cells - lymphocytes. There are several subspecies. B-lymphocytes are responsible for the acquired immunity to infectious diseases. By contacting a pathogenic microorganism, they eliminate its effect and retain it in its memory. B-lymphocytes are very important agents in the formation of a positive effect of vaccination. The major part (80%) of lymph is T-lymphocytes. They are responsible for the destruction of all kinds of viruses, bacteria. NK-lymphocytes are in lymph in a small amount (up to 10%). Their main function is the destruction of their own affected cells (including with a disease such as follicular lymphoma).

How does the malignant process develop in the lymphatic system

The tumor process begins to develop from the cells of the lymphatic system (B-lymphocytes). The disease is diagnosed mainly in the elderly, in children it occurs in isolated cases. Follicular lymphoma got its name due to the fact that the hair follicle is primarily affected. Very often neoplasms are observed in the neck, underarms, groin. A feature of such a lymphoma is that patients seek help very late. Affected lymphocytes penetrate into all internal organs, disrupting their work. Although follicular lymoma iiia is quite amenable to therapy, late diagnosis is not a complete way to get rid of the disease.

Possible causes of the disease

Experts can not name the exact reasons that contribute to the development of oncological diseases. However, there are a number of factors that increase the possibility of malignant formation. One of them is mutations of genes, chromosomes. Work in adverse conditions, constant contact with harmful chemicals can also become a catalyst for the development of a condition such as follicular lymphoma. Causes of the disease can be and such: exposure to radiation, immunodeficiency weakening of the body, autoimmune diseases. Some experts also highlight such factors as smoking, taking certain medications, and even obesity.

Symptomatic of lymphoma

Follicular lymphoma symptoms are quite weak, especially the initial stages. First of all, you can note a slight increase in lymph nodes. However, they remain painless. It is characteristic that a small swelling periodically disappears, then appears again. This fact should be especially alarming. The nodes inside the sternum also increase. Outwardly, it can manifest coughing, shortness of breath. A slight swelling of the face is possible. In some cases, the spleen suffers. Follicular lymphoma symptoms can have and quite common: weight loss, general fatigue, weakened body. However, these symptoms are rather an exception than the rule, they are observed only in one patient out of ten. The more severe stages of the disease are characterized by the defeat of the nervous system, in particular of the bone marrow. In this case, dizziness, nausea, and loss of consciousness is possible.

Classification and stages of oncological course

There are several types of lymphomas. The first is follicular. The content of follicles is 75%. If out of the range of 25-75%, it is a follicular-diffuse subspecies. In the diffuse type, less than 25% of the follicles are noted. Follicular lymphoma (iiia) occurs in several stages. At the initial stage, only one area of the lymph nodes is affected. The second stage is characterized by involvement in the pathological process of two or more sites (but on one side of the diaphragm). At the third degree, the areas on both sides of the diaphragm are affected. The heaviest fourth stage. Changes occur in internal organs and systems (bone marrow, liver, etc.). Sometimes the letters A or B are added to the numeral designation of the stage of lymphoma. This indicates whether the follicular lymphoma has the following signs: "B" - there is a change in body temperature (periodic increase), weight loss, sweating at night. Lymphoma with prefix "A" - these symptoms are absent.

Methods of diagnosis of lymphoma

First of all, a specialist (onco-hematologist) conducts a visual examination of the patient. Histological examination of the sample is mandatory. For this, a biopsy is performed. A piece of the affected lymph node is removed and examined under a microscope. It is worth noting three cytological types of disease, which require different treatments. The first type is characterized by the presence of up to five centroblasts in the field of view of the microscope, the second - up to 15 units. The second cytological type requires shock chemotherapy, as it is quite aggressive. Follicular lymphoma 3a of cytological type has the most unfavorable prognosis. In the field of view of the microscope, one can see extensive neoplasms. In addition, the patient must donate blood (oncomarkers, general analysis), undergo ultrasound examination of internal organs, CT or MRI. In order to determine whether the central nervous system is affected, a spinal cord is sampled for further investigation for the presence of cancer cells.

Follicular lymphoma. Treatment

Recently, the number of patients with a similar diagnosis has increased significantly. As a rule, the earlier it was possible to notice neoplasms, the more the patient has the chance to preserve his health and life. Lymphoma is characterized by a rather sluggish course, so in certain cases, doctors choose to wait and see all changes in the human body. It is due to the fact that both chemotherapy and surgical intervention do not pass without a trace and have their negative sides. The remission of follicular lymphoma can last several years. If oncological disease begins to progress, then therapy should be carried out immediately. Among the main methods of treatment should be allocated irradiation, chemotherapy, medications. Depending on the type of lymphoma, regional irradiation can prevent possible relapses. At the first stage of the disease, prolonged remissions were recorded in the majority of patients.

Conducting chemotherapy

Aggressive chemotherapy (mainly and using several drugs) in the early stages of lymphoma can significantly reduce the likelihood of relapses. For a long time this method was considered to be the main one in the treatment of oncological diseases. Chemotherapy is aimed at the destruction of tumor cells during their reproduction. Combined drugs are able to influence the fission process at different stages, so their application is more effective. However, chemotherapy has a destructive effect on other organs (skin, hair, etc.). Suffice from these drugs and bone marrow. During therapy, a person becomes more susceptible to infectious diseases, there may be multiple bruises, as well as bleeding. Often, treatment with drugs causes an increased production of uric acid, which leads to the formation of kidney stones. However, all the side effects disappear after a few weeks after the end of the course. It is worth noting that some chemotherapy drugs can lead to a decrease in the number of sperm in men, to provoke infertility in women.

Treatment with monoclonal antibodies

Follicular lymphoma is also treated with such new drugs as monoclonal antibodies. They deliberately destroy only cells of lymphoma. This method is especially effective in combination with chemotherapy. Monoclonal antibodies somewhat reduce the toxicity of chemicals. In patients, a prolonged remission of follicular lymphoma is observed. In some cases, an allergic reaction is possible, so the first administration of antibodies occurs for a fairly long time. Before starting treatment, the patient needs a course of antiallergic drugs.

Relapses of the disease

This disease is characterized by slow progression in the early stages, the period of remission can last up to 20 years. The most common recurrence of follicular lymphoma is observed at 3a cytological type. In this case, stem cell transplantation may be necessary . A donor can become both a brother (sister) and an uncircumcised relative. The procedure is performed for patients no older than 70 years who respond fairly well to chemotherapy and have a satisfactory state of health. After transplantation, improvements are observed in about half of the patients. Survival of patients depends on many factors. First of all, the stage of the disease, the morphology of the changes (the prognosis of follicular lymphoma at the fourth stage is quite unfavorable). It should be noted that young people better cope with the disease. It is very important to recognize lymphoma on time, so do not give up preventive examinations from specialists.