LYMPHOMA CANCER

Lymphoma is the name for a group of blood cancers that start in the lymphatic system or the Lymph nodes or glands. The lymphatic system is part of the body’s immune system – the body’s defense against infection. The marrow and lymphocytes are part of the immune system. Some other parts of the immune system are the lymph nodes, the lymphatic vessels, which connect the lymph nodes and contain lymph (a liquid that carries lymphocytes), and the spleen. Lymphomas generally start in lymph nodes or lymphatic tissue in sites of the body such as the stomach or intestines. Lymphomas may involve the marrow and the blood in some cases.

RESEARCH AND CLINICAL TRIALS

Many times, the first sign of lymphoma is a painless swelling in the neck, under an arm, or in the groin area. • An enlarged lymph node sometimes causes other symptoms by pressing against a vein or lymphatic vessel (swelling of an arm or leg), a nerve (pain, numbness, or tingling), or the stomach (early feeling of fullness). • Lymph nodes or tissues elsewhere in the body may also swell. The spleen, for example, may become enlarged in lymphoma. Most people have no other symptoms. However, additional symptoms may include: • Fevers • Chills • Unexplained weight loss • Night sweats • Lack of energy • Itching (up to 25% of patients develop this itch, most commonly in the lower extremity but it can occur anywhere, be local, or spreading over the whole body) These symptoms are nonspecific. This means that they could be caused by any number of conditions unrelated to cancer. For instance, they could be signs of the flu or other viral infection, but in those cases, they would not last very long. In lymphoma, the symptoms persist over time and cannot be explained by an infection or another disease. The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). These can occur in both children and adults. Most people with Hodgkin lymphoma have the classic type. With this type, there are large, abnormal lymphocytes (a type of white blood cell) in the lymph nodes called Reed-Sternberg cells.

PREDICTIVE ANALYSIS USING S/4 HANA IN EARLY DETECTION OF CANCER

Diffuse large B-cell lymphoma (DLBCL) is comprised of multiple diseases with different outcomes, cell of origin and molecular pathogenesis. DLBCL derived from germinal center B-cells (GCB) and activated B-cells (ABC) constitutes over 80% of DLBCL. A small number of DLBCL tumors harbor MYC translocations, which are associated with a poorer prognosis. Primary meditational B-cell lymphoma (PMBL) occurs in younger patients and is typically treated with intensive or combined modality therapy. R-CHOP is the standard of care for DLBCL but has not been prospectively studied within DLBCL molecular subtypes. DA-EPOCH-R is an alternative and more dose-intensive regimen that showed a PFS of 81% at 4-years in a phase II multicenter CALGB study (Haematologica 2012; 97:758). CALGB/Alliance undertook a phase III randomized study to compare R-CHOP and DA-EPOCH-R in DLBCL and specifically within the GCB and ABC subtypes.