low grade b cell lymphomas | Histological Classification of non-Hodgkin's lymphoma

Histological Classification of non-Hodgkin's lymphoma




Knowing the rank gives your care team an idea of how quickly non-Hodgkin's lymphoma (NHL) can develop and its likelihood of spreading. This helps him plan your treatment. The rank can also help the care team to predict how you might react to the treatment.

To establish the NHL rank, the pathologist examines a sample taken from a lymph node or other tissue microscopically. The grade is defined by the appearance and behavior of cancer cells that are compared with those of normal cells. The word differentiation is used to describe how different cancer cells are.

The different types and sub-types of NHL are usually described as indolent (low grade, or slow evolution) or aggressive (high grade, or rapid evolution). Some NHL sub-types cannot be easily categorized as they have indolent NHL and aggressive NHL characteristics.

Low-grade NHL, or indolentCancer cells of low grade, or indolent, are well differentiated. Their appearance and behaviour are very similar to those of normal cells.

Low-grade NHL types tend to grow slowly and usually cause few symptoms when developing. Low-grade NHL types have therefore often already spread to other parts of the body when diagnosed. They usually spread to the bone marrow and spleen.

Some types of low-grade NHL can turn into a high-grade NHL type that requires more aggressive treatment.

High-grade NHL, or aggressiveHigh-grade, or aggressive, cancer cells are poorly differentiated or undifferentiated. Their appearance and behaviour are less normal, or more abnormal.

High-grade NHL types develop rapidly. They tend to spread to lymph nodes or other organs in different parts of the body. High-grade NHL types usually cause symptoms and should be treated immediately.


Prognosis and survival for non-Hodgkin's lymphoma
If you have a non-Hodgkin's lymphoma (NHL), you may be asking questions about your prognosis. A prognosis is the act by which the Doctor best evaluates how the cancer will affect a person and how he or she would react to treatment. Prognosis and survival depend on many factors. Only a doctor who is familiar with your health history, the type of cancer you are diagnosed with, the stage and characteristics of the disease, the treatments selected and the treatment response can examine all of these data in conjunction with the statistics Survival to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person that the physician considers when making a prognosis. A predictive factor influences how the cancer responds to a certain treatment. Prognostic factors and predictive factors are often approached together and both play a role in the choice of treatment plan and in the prognosis setting.

Revised International prognostic Index
The revised International Prognostic Index (RIPI) is a newer version of the International Prognostic Index (IPI) that has been developed to help establish the outcome of people with an aggressive (fast-paced) NHL type.

The RIPI is based on treatments based on any new drugs including rituximab (Rituxan). It helps physicians to assign risk categories to people affected by the number of adverse prognostic factors they present. The RIPI uses the same factors as the IPI and divides people into 3 risk categories.

Age
People under 60 years of age tend to have a better prognosis than those who are over 60 years old.

Stage
The lower the NHL stage, the better the prognosis. The Stage 1 or 2 NHL results in a more favorable prognosis than the stadium 3 or 4 NHL.

LDH Rate (LDH)
A person with a normal blood level of LDH tends to have a better prognosis than a person with a high LDH level. A higher than normal LDH rate usually means that the cancer is more advanced. The LDH rate is often higher in people with a rapidly evolving NHL type.

Extraganglionnaire Propagation
When the NHL spreads to an organ or tissue located outside the lymph nodes, it is referred to as Extraganglionnaire propagation. An NHL that is found only in the lymph nodes is more likely to be treated effectively and produces a better prognosis than an NHL that has spread out of the lymph nodes.

Functional Index
The functional index is the measure of a person's ability to perform routine tasks as well as his or her daily activities. In general, the more active a person is and the more able it is to continue their daily activities, the better the functional index. People with a good functional index, or those who can function almost normally, usually have a better prognosis than those with a low functional index, i.e. those who need help in their activities Daily or who have to spend a lot of time in bed.

Risk categories of RIPI

The doctors assign the prognostic score according to the RIPI. One point is allocated to each adverse prognostic factor. The lower the number of adverse prognostic factors, the better the prognosis.

A very good prognosis is not related to any adverse prognostic factor.

A good prognosis is linked to 1 or 2 adverse prognostic factors.

A dark prognosis is linked to 3 or more adverse prognostic factors.

Physicians use RIPI to identify NHL cases that are likely to respond well to treatment and those likely to reappear (re-offend) after treatment.

Other prognostic factors

Physicians also take into consideration the following factors when evaluating the prognosis of the NHL.

NHL Type

People with B-lymphocyte lymphoma often have a better prognosis than those with T-cell lymphoma. Of the 2 most common types of B-lymphocyte lymphomas, follicular lymphoma generally produces a better prognosis than large B-cell diffuse lymphoma (LDGCB). Large-cell anaplastic lymphoma and cutaneous T-lymphoma are 2 subtypes of T-cell lymphoma that generate a fairly good prognosis.

Tumor Volume

The smaller the tumor, the better the prognosis. Small tumors tend to react better to treatment. Large tumors often produce a less favorable prognosis. A very large tumor (10 cm or more) can be called a large tumor.

Symptoms B

B symptoms include unexplained fever, significant night sweats and unexplained weight loss. If B symptoms are present, the prognosis is less favorable.

Hemoglobin levels

A person with a normal hemoglobin level has a better prognosis than a person with low hemoglobin levels.