T-Cell lymphoma

T-Cell lymphoma


T-cell lymphomas can arise in lymphoid tissues like the lymph nodes and spleen, as well as outside of them (i.e., gastrointestinal tract, liver, nasal cavity, skin, and others). T cells have a lot in common with natural killer (NK) cells, which are comparable lymphocytes. When NK cells turn malignant, it’s called NK or NK/T-cell lymphoma, and it’s usually lumped in with other T-cell lymphomas. According to the Surveillance, Epidemiology, and End Results programme, T-cell lymphomas account for roughly 7% of all NHLs in the United States. T-cell lymphoma is extremely rare in each of its subtypes. They might be aggressive (rapid growing) or passive (slow growing) (slow-growing).

Lymphomas are frequently, but not always, called after a description of a healthy cell that turns cancerous. Lymphomas that have spread throughout the body.


Types of t-cell lymphoma

PTCLNOS is for Peripheral T-Cell Lymphoma, Not Otherwise Specified, and describes a collection of diseases that don’t fall into any of the other PTCL categories. The most frequent PTCL subtype is PTCL-NOS, which accounts for around 20% of T-cell lymphomas. Although most individuals with PTCL-NOS have disease that is limited to the lymph nodes, other organs such as the liver, bone marrow, gastrointestinal system, and skin may also be affected. Constitutional symptoms are common in patients with this subtype of PTCL (i.e., fevers, serious night sweats, and unexplained weight loss).

Anaplastic Large Cell Lymphoma (ALCL) is a term that refers to a variety of T-cell lymphomas. It accounts for about 1% of all NHLs and 11% of all T-cell lymphomas. Fever, backache, painless swelling of lymph nodes, loss of appetite, itching, skin rash, and weariness are some of the first signs of ALCL. ALCL can be either systemic (affecting the entire body) or cutaneous (affecting only the skin) (limited to the skin). When diagnosed, systemic ALCL is usually in an advanced stage and can progress quickly. The ALK-positive or ALK-negative systemic subtype is determined by whether or not it contains an aberrant anaplastic lymphoma kinase (ALK) fusion protein as a result of a genetic event. Systemic ALCL, particularly ALK-positive illness, has a good prognosis and may be treatable. ALK-negative patients may require more aggressive treatments, and relapse (disease returns after treatment) occurs more frequently than in ALK-positive disease. The non-systemic type is called primary cutaneous anaplastic large cell lymphoma, appears only on the skin, and has a good prognosis.

Angioimmunoblastic T-Cell Lymphoma (AITL) is a rare and aggressive kind of T-cell lymphoma that affects around 7% of T-cell lymphoma patients in the United States. The majority of patients are in their middle to late years of life and have been diagnosed with advanced-stage cancer. There is some indication that AITL develops as a result of a persistent immunological response, maybe as a result of a latent viral infection (like Epstein-Barr virus). Fever, night sweats, skin rash, itching, and autoimmune illnesses such autoimmune hemolytic anaemia (AIHA; where the immune system assaults red blood cells) and immune thrombocytopenia are common early signs (ITP; where the immune system attacks platelets).

Cutaneous T-Cell Lymphoma (CTCL) is a kind of NHL that affects adults and accounts for two to three percent of all NHL cases. The term cutaneous T-cell lymphoma refers to a group of indolent lymphomas that appear on the skin and are mostly contained there. The most prevalent variety of CTCL is mycosis fungoides, which manifests as skin patches, plaques, or tumours. Patches are flat, scaly lesions that resemble a rash; plaques are larger, raised, painful lesions that are frequently mistaken for eczema, psoriasis, or dermatitis; and tumours are elevated bumps that may or may not ulcerate. At any given time, more than one type of lesion may be present. Sézary syndrome is a rarer type of CTCL that affects both the epidermis and the bloodstream. Most cases occur in adults over the age of 60 years. The most common symptoms are swollen lymph nodes and a red, very itchy rash that covers large portions of the body. Abnormal T cells, called Sézary cells, can be seen under a microscope and are present in both the skin and blood. Other, rare forms of CTCL include primary cutaneous anaplastic large cell lymphoma and lymphomatoid papulosis.


Symptoms of cutaneous T-cell lymphoma

Signs and symptoms of cutaneous T-cell lymphoma include:

  • Round patches of skin that may be raised or scaly and might be itchy
  • Patches of skin that appear lighter in color than surrounding skin
  • Lumps that form on the skin and may break open
  • Enlarged lymph nodes
  • Hair loss
  • Thickening of the skin on the palms of the hands and soles of the feet
  • A rash-like skin redness over the entire body that is intensely itchy


Causes of T-cell lymphoma

It’s unclear what causes cutaneous T-cell lymphoma.

In general, cancer develops when cells’ DNA undergoes alterations (mutations). The DNA of a cell carries instructions that tell it what to do. The DNA mutations instruct the cells to expand and multiply quickly, resulting in a large number of aberrant cells.

Mutations in cutaneous T-cell lymphoma cause an overabundance of aberrant T cells that attack the skin. T cells are immune cells that ordinarily assist your body in fighting pathogens. Doctors are baffled as to why the cells are attacking the skin.


Diagnosis of T-cell lymphoma

T-cell lymphomas are uncommon and difficult to detect. Your doctor may refer you to specialists who specialise in T-cell lymphoma. Your doctor may recommend you to one of these centres in some instances. It’s critical to determine the type of T-cell lymphoma you have and where sections of your body are affected so that your doctor can determine the best treatment option for you. Your care is likely to involve a number of different healthcare providers.

A biopsy is frequently used to diagnose T-cell lymphoma. An professional lymphoma pathologist removes a sample of lymphoma-affected tissue, such as a swollen lymph node, and examines it. A pathologist examines the tissue to determine the type of lymphoma you have.

Blood tests are also performed to assess your overall health, check your blood cell counts, ensure that your kidneys and liver are functioning properly, and rule out infections that could flare up during treatment.

Other tests can be used to determine whether parts of your body are impacted by lymphoma. This is referred to as staging. A PET scan and a CT scan are generally used for staging. An MRI may be required for some patients, particularly children.

Because the lymphatic system is distributed throughout the body, T-cell lymphoma is frequently identified at an advanced stage. Despite the fact that this sounds frightening, advanced lymphoma can be treated.

Your tests are normally done as an outpatient procedure. Getting all of the results together to confirm the accurate diagnosis can take a few weeks. Waiting for test results can be stressful, but it is critical for your doctor to gather all of this information so that you can receive the best treatment possible.


Treatment of T-cell lymphoma

T-cell lymphomas are being studied by lymphoma specialists and researchers who are looking for new ways to improve therapy and results. Clinical trials are being conducted on a number of specific medications. Your doctor may ask if you want to participate in a clinical study to evaluate new medicines.

Most T-cell lymphomas have previously been treated with chemotherapy outside of clinical trials. The CHOP treatment is the most often used combination chemotherapy regimen:

  • cyclophosphamide
  • doxorubicin (or hydroxydaunorubicin)
  • vincristine (also known as Oncovin®)
  • prednisolone (a steroid).

Some specialists might add a chemotherapy drug called etoposide to CHOP (CHEOP), or you might have a different chemotherapy regimen altogether. If you are not fit enough to have CHOP or CHEOP, you might be treated with less intensive chemotherapy, such as gemcitabine or bendamustine.

Your doctor might recommend a self (autologous) stem cell transplant for younger people with T-cell lymphoma who have responded well to initial chemotherapy and are well enough. For some types of T-cell lymphoma, this could give you a better chance of staying in remission (no evidence of lymphoma) after treatment.


CAR T-Cell therapy in T-cell lymphoma

At present CAR T-cell therapy is available for B-Cell Non-Hodgkin Lymphoma, however clinical trials are on for T-cell lymphoma also. 


Please call +91 96 1588 1588 or write to info@cancerfax.com to know more about these clinical trials and participate in them.


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  • March 25th, 2022

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