Common Lymphoma Terms
A
ACUTE MYELOID LEUKAEMIA (AML)
A rapidly progressing cancer of the blood affecting immature cells of the bone marrow, usually of the white cell population. It is more common in adults than in children.
ALLOGENEIC STEM CELL or BONE MARROW TRANSPLANT
A stem cell transplant using marrow collected from a matched healthy donor, usually a brother or sister. The risk associated with such a transplant increases with age and 55 has until now been regarded as the upper age limit for patients.
ALOPECIA
The loss of hair. A side-effect of some forms of chemotherapy or radiotherapy used to treat cancers. Usually temporary.
ANAEMIA
Deficiency of red blood cells and/or the oxygen carrying pigment haemoglobin in the blood. Causes pallor and tiredness.
ANTIBODIES
Naturally produced substances in the blood that destroy or neutralise specific toxins or foreign bodies, for example, viruses. They are produced by the white blood cells known as lymphocytes in response to expose to the antigens of the foreign body against which they act. They form an important part of the body's defence system against infection.
ANTI-EMETIC
A drug to prevent or alleviate nausea and vomiting that can sometimes be a side-effect of chemotherapy. Drugs of this type include metoclopramide (maxolon), zofran (ondansetron).
ANTILYMPHOCYTE GLOBULIN
Antibodies that attach to and destroy lymphocytes. This may be used clinically by injection into a vein, for example, in aplatic anaemia or in other conditions where the body's immune system is being harmful. (See also auto-immune diseases)
AUTO-IMMUNE
A disease caused by an individual's immune system producing antibodies against tissues of its own body. The type of antibody so produced must have an adverse effect in the body, as some antibodies are necessary for normal function. Examples include some haemolytic anaemias, rheumatoid arthritis and systemic lupus erythematosis (Lupus).
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B
B CELL (B LYMPHOCYTE)
A type of white blood cell normally involved in the production of antibodies to combat infection. The mature B cell is often called a plasma cell. An antibody 'sticks' to an antigen on a foreign cell, causing the antibody-antigen cell to be destroyed or to break down. Tumours of mature B cells result in B cell lymphoma and sometimes myeloma.
BASOPHIL
A type of white blood cell which is involved in allergic and inflammatory reactions. Normally present in low numbers in the blood. It is called a basophil because the granules in the cell take up basic dye in a test tube and can be recognised under the microscope.
BIOPSY
A small sample of fresh tissue, lymph node or bone marrow, removed for laboratory analysis to establish exact diagnosis.
BLOOD CELLS
There are three main types of cells in the bloodstream - the red blood cell, which carries oxygen, the white blood cell, which fights infection, and the platelet, which helps prevent bleeding. The correct balance between each cell type must be maintained for the body to remain healthy.
BLOOD COUNT
A routine test requiring a small blood sample to estimate the number and type of cells circulating in the blood.
BONE MARROW TRANSPLANT
A procedure called stem cell transplant, used in the treatment of a variety of bone marrow disorders including leukaemia, lymphoma and myeloma. The patient receives very high doses of chemotherapy and/or radiotherapy to treat the disease. This empties the bone marrow and makes the blood count fall. Replacement marrow is taken from a matched donor (allogeneic stem cell transplant) or from the patient's own bone marrow (autologous stem cell transplant) and returned to the patient through a vein (or central venous line) in similar way to a blood transfusion.
BURKITT'S LYMPHOMA
A rapidly growing type of non-Hodgkin's lymphoma. First described in Africa where it may present as a cancer of the facial bones. However, in other countries it more usually affects the abdomen. It requires immediate treatment and is uncommon in western countries.
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C
CANCER
Disease due to the uncontrolled growth, accumulation, division and maturation of cells; often called malignant disease or neplasia. It causes problems as a result of the cells acquiring abnormal ailments or losing normal activities.
CT SCAN (CAT SCAN)
Computer assisted tomography (CAT) is a complex x-ray technique used to produce serial detailed internal images of any part of the body. The patient lies on a couch, which gradually moves through the x-ray machine, and the image is built up by a computer as a cross-section of the body. It is a special type of tomography.
CATHETER
A hollow tube inserted into organs of the body for admitting or removing gases or liquids. For example, for the removal of urine from the bladder.
CHEMOTHERAPY
Treatment using anti-cancer drugs. These may be used singly or in combination to kill or prevent the growth and division of cells. Although aimed at the cancer cells, modern chemotherapy will still, to a degree, unavoidably affect rapidly dividing normal cells such as in the scalp and gut, causing hair loss and nausea, which are usually temporary and reversible. There are a range of substances under development that may be able to protect the normal cells during chemotherapy treatment.
CHRONIC LEUKAEMIA
A persistent cancer of the blood, usually of gradual onset and generally of slow progression. May be diagnosed by chance following a routine blood test and before clinical symptoms appear. The leukaemia is usually called chronic because the leukaemic cells are more mature than acute leukaemia cells.
CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL)
A slowly progressing form of leukaemia characterised by an increased number of the type of white blood cells known as lymphocytes. It is the most common form of leukaemia and occurs predominantly in late middle age onwards. It has variable symptoms and unknown cause but may be diagnosed by chance long before the patient develops any clinical symptoms of disease.
CHRONIC MYELOID LEUKAEMIA (CML)
A leukaemia which is initially slow progressing. It is characterised by the presence of large numbers of abnormal mature granulocytes circulating in the blood. Often referred to as chronic granulocytic leukaemia (CGL) and typically will transform over time to acute leukaemia.
CHRONIC MYELOMONOCYTIC LEUKAEMIA (CMML)
A form of myelodysplasia characterised by an increase in the number of circulating white blood cells of monocyte type. It may transform into acute leukaemia or patients may develop problems with infection or bleeding.
CLINICAL TRIAL
A controlled and carefully monitored assessment of new forms of treatment. Trials can vary in design and size from small-scale trials of experimental treatments to large national trials that compare subtle variations in current therapies. The patient will be informed and will always be given the option not to join, or not without detriment to their treatment when their treatment is part of a trial.
CLINICAL HAEMATOLOGIST
A specialist trained as a physician and pathologist to diagnose and treat diseases of the blood, marrow and lymph glands, eg the person who normally diagnoses and treats leukaemia, lymphoma and myeloma.
CORTICOSTERIODS (STEROIDS)
A group of synthetic hormones including prednisone, prednisolone, methylprednisolone and dexamethasone used in the treatment of some leukaemia and also to suppress graft rejection and graft versus host disease following bone marrow transplant. Side effects include an increased risk of infection, weight gain, and sometimes bone softening with long term use.
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D
DENDRITIC RETICULIN CELLS (DRC)
Cells of bone marrow origin whose job is to present antigens from foreign agents to the immune cells to allow the development of immunity. These cells may one day be used in therapy to enhance the immune system against cancer cells.
DIPHOSPHONATES
A very important drug type used to prevent or treat high calcium levels in cancer. It is very useful in strengthening bones in breast cancer and myeloma to prevent fractures and pain.
DIURETIC
A drug to increase the production of urine by the kidneys. May be used during chemotherapy to assist the excretion of anti-cancer drugs.
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E
ECHOCARDIOGRAM
Ultrasound scan of the heart.
ELECTROCARDIOGRAM (ECG)
Electrical trace of the heart.
ELECTROENCEPHELOGRAM (EEG)
Electrical brain recording.
ELECTROLYTES
Various salts in the blood. Measurement helps to monitor kidney function.
EMBOLUS
A blood clot that starts in the leg or other distant vein or artery, which breaks loose only to lodge elsewhere in the body and block blood supply. For example, a clot in a vein may cause a problem in the lung, (pulmonary embolism).
EOSINOPHIL
A type of white blood cell involved in inflammatory, allergic or antiparasitic responses. Usually present in the circulation in very low numbers. It is called an eosinophil, as cells in a test tube take up acidic (eosinophilic) dyes.
EOSINOPHILIA
Increased numbers of eosinophils circulating in the blood. It occurs occasionally in some cases of Hodgkin's disease, in drug reactions, in asthma, hayfever and parasitic infections.
EPSTEIN BARR VIRUS
A common virus which causes glandular fever. Also associated with Burkitt's lymphoma. Epstein and Barr first described this virus.
ERYTHROLEUKAEMIA
A rare cancer of the blood affecting immature red blood cells, eg acute erythroleukaemia which is a type of myeloid leukaemia.
EXTRA NODAL LYMPHOMA
A lymphoma that presents outside the lymph nodes, but in tissues containing lymph cells. A term used to describe the extent and site of disease.
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F
FOLIC ACID
A vitamin necessary for marrow cell growth that is obtained from green leafy vegetables, for example, spinach. It is essential for production of DNA and therefore the growth and division of cells.
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G
GALLIUM SCAN
A way of looking at the spread of lymphoma by injecting a dye that is taken up by active lymph glands. A way of staging lymphoma and Hodgkin's disease. This test takes a couple of days to read.
GRAFT VERSUS HOST DISEASE (GVHD)
A common, and sometimes serious, complication of allogeneic stem cell transplantation. Some of the donor's immune cells try to reject the patient's own cells as foreign. The skin, liver and gut may be affected. It can occur in either chronic or acute forms and is treatable by immunosuppressive drugs. It is the cause of most of the deaths following transplantation.
GRAFT VERSUS LEUKAEMIA (GVL)
Cells either identical to or similar to the cells that cause GVHD disease (usually mature T lymphocytes). GVL is a very important mechanism in stem cell (bone marrow) transplants. Much effort is being expended in trying to separate cells responsible for GVL from GVHD in the hope of reducing risk of transplantation without losing efficacy.
GRANULOCYTE
A type of white blood cell containing granules in its cytoplasm (eg neutrophil, eosinophil, basophil). They protect the body against infection by seeking out and killing micro-organisms. Neutrophilic granulocytes are commonly called neutrophils.
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H
HAEMATOLOGIST
A doctor specialising in the diagnosis and treatment of blood diseases.
HAIRY CELL LEUKAEMIA
A rare leukaemia distantly related to chronic lymphocytic leukaemia and characterised by the presence of abnormal cells with hair-like projections. It occurs in middle age onwards. Treatment may involve removal of the spleen but usual current therapy is a single course of the drug 2-chlorodeoxyadenosine (2CDA) which usually induces sustained remissions.
HARVESTING
Removing tissue or cells from a donor and preserving them for transplanation.
HICKMAN CATHETER
A narrow plastic tube inserted through the skin, under anaesthetic, into a major blood vessel in the chest. It is used for patients undergoing intensive therapy and provides a route for taking blood samples and the administration of drugs without repeated needle puncture of a vein. It may have a single, double, or triple tube or lumen. Other companies produce similar venous access devices with different names.
HODGKIN'S DISEASE
A type of lymph gland tumour named after Thomas Hodgkin, who first described the disease in the 19th Century.
HTLV
Human T cell lymphotropic virus. A family of viruses which invade T cells. Includes a rare leukaemia virus, HTLV-1, found primarily in Japan and the Caribbean, causing an increased incidence of T cell leukaemias in these populations. The family also includes the AIDS-causing virus, HIV.
HYPERCALCAEMIA
Abnormally high levels of calcium in the blood. It is commonly associated with multiple myeloma due to degradation of the bones but can occur in other cancers such as lung cancer. It is dangerous if not controlled and leads to constipation, confusion, dehydration and renal failure and death due to heart irregularity. It is now commonly controlled by tables or infusion of bonefos or aredia (diphosphonates).
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I
IMMUNE DEFICIENCY
Impaired ability of the body's defence mechanisms to combat infections by bacteria, viruses and fungi and may also imply impaired surveillance of a resistance to cancer.
IMMUNOSUPPRESSION
A treatment induced reduction the body's defence mechanisms. Deliberate immunosuppression is a necessary part of the bone marrow transplant procedure to prevent graft versus host disease and graft rejection.
IMMUNOTHERAPY
Treatment of disease by inducing, enhancing, or suppressing an immune response.
INFUSION
The giving of antibiotics, blood products, anti-cancer drugs or nutrients into a patient's vein over a prolonged period of time.
INTERFERONS
A family of proteins derived from human cells which normally has a role in fighting viral infections. It is now available as a product of molecular engineering to be used in the treatment of leukaemia and leukaemia related diseases including malignant lymphoma, chronic myeloid leukaemia and myeloma.
INTRATHECAL INJECTION
The giving of drugs into a vein through a needle.
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L
LEUCOCYTES
Collective term of white blood cells. Leuco=white; cyte=cell.
LEUCOPENIA
Condition in which the number of white cells in the blood is greatly reduced. Leads to increased risk of infections.
LYMPHOID
Pertaining to the lymphatic system including lymphocytes, lymph nodes and lymph cell channels.
LYMPHOMA
A cancer of lymphatic cells whose normal counterparts have already left the bone marrow to be found in lymph glands and spleen and other tissues. Lymphoma can spread back to involve the bone marrow and blood and then look like leukaemia. The disease results from the uncontrolled production of the white blood cell known as the lymphocyte. The general term includes about a dozen different forms of the disease but there are two main categories: Hodgkin's disease and non-Hodgkin's lymphoma. Although this is an old-fashioned term it is still commonly used as a term of convenience.
LYMPHOPROLIFERATION
An increase in the production of lymphocytes. This may occur as a normal response to infection for the whole marrow or for only part. Only lymph cells are involved.
LYMPH NODES OR GLANDS
Structures found throughout the body, for example, in the neck, groin, armpit, and abdomen, which contain both mature and immature lymphocytes. There are millions of very small lymph glands in all organs of the body.
LYMPHOCYTE
A type of white blood cell which is involved in the immune defences of the body. There are two main groups - B cells (which make antibodies) and T cells (involved in cell-to-cell combat).
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M
MAGNETIC RESONANCE IMAGING (MRI)
A body scanning technique, which uses an intense magnetic field to generate images of the internal organs. Properties of normal and cancerous tissue differ, allowing malignant tumours to be visualised by the computer processing of the signals detected. It also is very good for detecting blockages in veins.
MONONCLONAL ANTIBODIES
Highly specific antibodies produced by cells grown in the laboratory. Current research is investigating their clinical application for targeted delivery of drugs to leukaemia cells. Some antibodies against lymphoma have been developed which are directly toxic to lymphoma cells.
MULTIPLE MYELOMA
A cancer caused by uncontrolled growth or proliferation of mature lymph cells specialised to make antibodies (called plasma cells) within the bone marrow. The abnormal cells do not usually accumulate in the blood and the tumour growth is often restricted to the bones but may spread locally beyond the bones. This leads to bone destruction and is often associated with kidney problems. The damage done by myeloma is a result of the abnormal properties of the secreted antibody, eg bone softening, high calcium content and blood thickening.
MYELOFIBROSIS
A disease in which the bone marrow is taken over by fibrous tissue and is no longer able to produce adequate numbers of mature blood cells. It is a myeloproliferative disease overproducing scar tissue. Often accompanied by enlargement of the spleen. It is occasionally found secondarily in cases of acute myeloid, acute lymphoid, or chronic myeloid leukaemia.
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N
NEUTROPENIA
A condition in which the neutrophil count is reduced. It may be caused by high dose chemotherapy and carries an increased risk of infection. It also may result from vitamin deficiency, the effect of drugs or viruses.
NEUTROPHIL
The most common type of cell within the granulocyte group of white blood cells. A neutrophilic granulocyte.
NON-HODGKIN'S LYMPHOMA
A group of lymphoma that differs in important ways from Hodgkin's disease and is classified according to the microscopic appearance of the cancer cells. The disease is classified either as low grade (slow growing), intermediate grade or high grade (rapidly growing) and may be treated in a variety of ways depending on the exact diagnosis.
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O
ONCOLOGIST
General term for a specialist who treats cancer by different means, eg medical, surgical, radiation oncologist.
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P
PLASMA CELLS
Large B cells derived from mature lymphocytes. Not normally found in circulating blood but restricted to bone marrow and lymph nodes. They are fully grown B lymphocytes.
PLATELETS
Tiny cell-like bodies derived from megakaryocytes in the bone marrow. They circulate in the blood and play an important role in the prevention and control of bleeding. Normal values, 150-400 x 109 per litre.
PURGING
The laboratory treatment of bone marrow harvested from a patient for an autologous bone marrow stem cell transplant with the aim of removing any residual leukaemic cells and thus reducing the theoretical chance of relapse. The use of this procedure varies between treatment centres and depends on the type of leukaemia being treated.
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R
RADIOTHERAPY
The use of X-rays and other forms of radiation in treatment. It kills cancer cells in the area of the body being treated and is therefore effective treatment for localised disease, particularly in lymphoma and multiple myeloma. Side-effects vary according to the type of treatment and will be discussed with the patient by the hospital staff. It can be administered by injection, by an external beam or by internally placed tube (brachytherapy).
RED BLOOD CELLS
The cells of the blood which contain the red pigment haemoglobin and carry oxygen to all the tissues of the body. Normal red cell count in the blood is 4.5 - 5.0 x 1012 per litre. They are the petrol tankers of the blood which carry oxygen.
REMISSION
Restoration of the blood, bone marrow and general health of the patient to normal. Induced by chemotherapy and/or radiotherapy.
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S
SEPTICAEMIA
This is a general term to describe serious bacterial infection in the body with leakage into the blood of substances which cause high fever and sometimes shock.
SPLENECTOMY
Surgical removal of the spleen. This is sometimes done in leukaemia or lymphoma as part of a patient's treatment.
STAGING
As assessment of the spread of disease through the body, for example, in lymphoma. Stage I usually means localised disease only, whereas stage IV represents widespread disease. Staging is of importance for the selection of the best treatment.
STEM CELLS
The most primitive cells in the bone marrow from which all the various types of blood cells are derived. These can be normal or leukaemic.
STEM CELL TRANSPLANT
The more modern and correct term for 'bone marrow transplant'. Stem cells can be collected from the blood by apheresis or blood separation machines after mobilisation. They are still sometimes collected by separation of stem cells from bone marrow collected directly from the bone. This is usually done by inserting a needle into the hip bone under a general anaesthetic. Stem cell transplants can be autologous (collected from the patient) or allogeneic (collected from another person who is usually a matched brother or sister). Occasionally stem cells can be collected by separation from the umbilical cord discarded after the birth of a baby (cord blood stem cells). These cord blood stem cells can be stored against future need.
SUBCUTANEOUS INJECTION
An injection into tissue immediately under the skin.
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T
T CELL (T LYMPHOCYTE)
A type of white blood cell derived from the thymus (hence T cells) involved in controlling immune reactions. Uncontrolled growth of this type of cell gives rise to T cell leukaemia/ lymphoma.
THROMBOSIS
The development of a clot in a blood vessel, usually in a vein but sometimes in an artery. Potentially life-threatening if left untreated.
THYMUS
A gland at the base of the neck concerned with the production of function T cells. Lymphocytes destined to be thyplocytes are 'finished' in the thymus after they leave the bone marrow.
TRANSFORMATION
A term to describe either the change of a normal cell into a cancerous cell, or the acceleration of disease (eg in chronic myeloid leukaemia from the chronic to a mroe acute phase characterised by the production of large numbers of blast cells). Also occurs in CLL (rarely) and low grade lymphoma.
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W
WHITE BLOOD CELLS (ALSO LEUCOCYTES)
They comprise several different types of cells within three main groups: granulocytes, lymphocytes and monocytes. They are formed in the bone marrow and it is usually their uncontrolled proliferation that leads to leukaemia. Normal values are within the range 4.5 - 11.0 x 109 per litre.