T-cell lymphoma: peripheral, angioimmunoblast, non-Hodgkin's, anaplastic
Cancer is considered one of the most dangerous human diseases. And if you take into account that under the terrible diagnosis there are several types of a deadly disease that have interrupted the lives of many people, then willy-nilly you will become interested in this issue in order to avoid such a fate. Take, for example, one of the most dangerous types of blood cancer, affecting the lymphatic system and skin, called T-cell lymphoma. It is because of this pathology that many elderly people do not live up to the long-awaited pension or enjoy it for a very short time. Although, frankly speaking, the risk group for developing this pathology needs to be recorded not only by the elderly.
Epidemiology
With regard to lymphoma statistics, T-cell lymphoma has a prominent place among cancerous pathologies of the blood, observed in the older age. However, it can hardly be called a disease of the elderly, as there have been many cases of even children and adolescents. Moreover, men are more predisposed to the disease than women.
The epidermotrophic nature of the pathology suggests that the disease is localized mainly in the skin, organ shells and lymph nodes in the immediate vicinity of them. In this case, the most common form of the disease is T-cell lymphoma of the skin, and in particular mushroom mycosis.
Causes of the t-cell lymphoma
Lymphoma is a tumor that consists of modified cells of the lymphatic system. In the case of T-cell lymphoma, T-cells (T-lymphocytes) developing in the thymus gland from pre-mitocytes, which are contained in the red bone marrow, from where they migrate into the thymus become participants in the pathological process.
T-lymphocytes are a factor that provides the body's immune response to various external influences and regulates the processes taking place inside it. So any inflammatory process in the body causes the redistribution of T-lymphocytes, which accumulate near the lesion in the course of the lymph flow. After the inflammation is stopped, the lymph nodes acquire the original size and elasticity. Alas, this does not always happen.
Scientists are not yet ready to give a full answer to the question what causes uncontrolled accumulation of lymphocytes at one point for no apparent reason, and that causes mutation of the cells of the lymphatic system, which begin to intensify division (proliferation), leading to undesirable proliferation of tissues within the body. Uncontrolled cell proliferation leads to an increase in the size of the lymph nodes and organs into which mutated T lymphocytes are supplied. This all causes dangerous violations of the organs and glands, leading to the death of the patient.
Most scientists tend to believe that T-cell lymphoma is a consequence of unidentified leukemia (aka leukemia). With leukemia, there is the appearance of mutated cells, formed from immature hemocytoblasts of the bone marrow, which are the precursors of blood cells. With T-cell leukemia, mutations of lymphoblasts and protymocytes, the precursors of T-lymphocytes, are observed.
Such malignant clones from the red bone marrow can also enter the thymus, and from it in the form of mutated T-lymphocytes prone to uncontrolled proliferation and into the lymphatic system. Thus, Type 1 T-cell leukemia (HTLV 1-Human T-lymphotropic virus 1), which belongs to the family of retroviruses, is the most likely cause of T-cell lymphoma.
However, this theory does not explain the muggling of mature T-lymphocytes, which initially did not differ in pathogenicity. It turns out that they experienced the negative influence of some other factors, in addition to the HTLV 1 virus, which led to mutations.
As one of the theories of the formation of T-cell lymphoma, the hypothesis of a negative effect on the quality of lymphocytes of certain viruses (for example, herpes virus type 6 and type 4, hepatitis virus, HIV) is being considered. These viruses are often found in patients with blood cancer, and therefore exclude their influence is impossible.
Since the production of T-lymphocytes is carried out under the control of the immune system, any discrepancy in its work can lead to increased production of T-lymphocytes from unsuccessful ripening of bone marrow cells and a greater probability of chromosomal mutation in them. An inadequate response of the immune system to stimuli can also occur in the form of clusters in the epithelial layers of the skin of rapidly dividing clones of lymphocytes, leading to the formation of microabscesses, which is observed with T-cell lymphoma of the skin.
Simultaneously with the proliferation of lymphocytes, there is a decrease in the activity of cells that provide pro-tumor protection.
Lymphocytes and some other cells in the body are capable of producing special information molecules called cytokines. These molecules, depending on their type, ensure the interaction of cells with each other, determine the term of their life, stimulate or inhibit cell growth, their division, activity and death (apoptosis). They also ensure the coordinated work of the immune, nervous and endocrine glands. Among the cytokines, there are molecules that inhibit inflammatory and tumor processes, and those that regulate the immune response. Reducing the activity of these molecules can open the way to the formation of tumors.
Risk factors
Risk factors for the development of T-cell lymphoma can be considered:
- Inflammatory processes in the body that cause a corresponding reaction of the immune system and lead to the accumulation of lymphocytes in the affected area.
- The presence in the body of a viral infection (herpes viruses 1,4 and 8 types, hepatitis B and C viruses, lymphocyte virus, HIV infection and even chalikobacter pylori).
- Inadequate functioning of the immune system due to earlier mutations and structural changes. It is about autoimmune pathologies, the introduction of immunosuppressants into the body, which depress the work of the immune system.
- Prolonged contact with substances-carcinogens.
- Hereditary predisposition and congenital immunodeficiency states.
- Prolonged exposure to ionizing and ultraviolet radiation, some chemicals causing lymphocyte mutations.
- Chronic course of various types of dermatosis (psoriasis, atopic dermatitis, etc.), leading to a prolonged finding in the affected area of lymphocytes, provoking a decrease in immunity and reproduction of malignant clones in the local zone. This can lead to the formation of a malignant process on the skin.
- Old age.
Most often, the cause of the disease is not one cause, but the combined effect of several factors. Perhaps that is why specific manifestations of the disease are observed mainly in adulthood, after the organism for a long time experienced the negative influence of many factors.
Symptoms of the t-cell lymphoma
Speaking about the symptoms of the disease, it is necessary to understand that the diversity of T-cell lymphoma species will leave its imprint on the clinical picture of the disease in each specific case. Nevertheless, there are some common signs that are characteristic of many oncological pathologies.
The first, albeit nonspecific, signs of the development of the disease are:
- a causeless decrease in appetite, a violation of the digestive process,
- weight loss, despite the fact that the amount and calorie content of food did not undergo significant changes,
- chronic weakness, decreased ability to work,
- apathy to what is happening around,
- an increased response to stress factors,
- increased sweating (hyperhidrosis), especially at night,
- a constant slightly elevated temperature (the subfebrile temperature is within 37-37.5 degrees),
- chronic constipation, if the tumor is localized in the pelvic region,
Specific symptoms of T-cell lymphoma are:
- not passing in the increase in the size and compaction of the lymph nodes,
- increase in the size of internal organs (most often liver and spleen),
- redness and burning of the skin, the appearance on it of rapidly expanding lesions in the form of ulcers, plaques, papules,
- violation of the structure (destruction) of bone tissue.
Forms
The disease can have a different course in connection with which the following forms of pathology are distinguished:
- The acute form.
It is characterized by rapid development of the disease. From the appearance of the first signs and until the disclosure of all symptoms, no more than 2 weeks pass to the full. Such a course of the disease is noted in more than half of all patients diagnosed with T-cell lymphoma.
The increase in lymph nodes with this form of pathology is usually absent. Death occurs within six months from the onset of the disease from complications in the form of pneumonia, infection in the affected areas of the skin, destruction of bones with poisoning the body with decay products, reducing immunity, leptomeningitis with mental disorders, etc.
- Lymphogenesis form.
Similar to the above in the clinical picture. However, one of the symptoms of pathology is an increase in lymph nodes. This course of the disease is noted in a fifth of patients.
- Chronic form.
The clinical picture emerges completely for a longer time and is less pronounced. In this case, the nervous, digestive and osseous systems do not suffer if the disease does not become acute. Patients live with a pathology of about 2 years.
- Ember form.
The rarest form of the disease, typical of 5 patients out of 100. There is a small amount of mutated T-lymphocytes, proliferation occurs more slowly than with other forms of lymphoma. Nevertheless, the symptoms of skin and lung damage are noticeable. Life expectancy of patients is about 5 years.
In more detail about the manifestations of T-cell lymphoma, we will talk about different types of pathology and the features of their course.
Since T-cell lymphomas can differ not only in the localization of the pathological process, but also in external manifestations and the mechanism of formation, it is customary to classify them into the following types:
The cause of these tumors are mutations of mature T-lymphocytes under the influence of unfavorable factors (viruses, radiation, burns), as a result of which they are able to actively multiply to form clusters of mutated clones in the epidermal layer.
Clinical picture: the appearance on the skin of various rashes (plaques, blisters, spots, papules, etc.).
Pathology usually occurs in 3 stages. At the beginning of the disease, patients note the appearance of eczematous spots, which begin to itch and flake, then in their place appear plaques, gradually growing and rising above the surface of the body. Further to the "wrong" lymphocytes in the skin are cloned mutants, circulating through the lymphatic system, cancer gives metastases, which leads to the death of the patient for 2-5 years.
- Peripheral T-cell lymphoma.
This concept includes all tumor elements formed by T- or NK-lymphocytes (anti-inflammatory elements and natural killers, providing an antitumor effect). Only mature cells prone to excessive proliferation are included in the process. Such lymphomas can form in the lymph nodes and on the internal organs near the affected lymph nodes. They affect the quality of blood, the state of the skin and bone marrow, lead to the destruction of bone tissue.
Clinical picture: an increase in lymph nodes in the neck, groin and underarms. This type of pathology is characterized by nonspecific symptoms of the disease described above, plus some unpleasant manifestations associated with an increase in organs (usually the liver and spleen). Patients report difficulty with breathing, repeated causeless cough, heaviness in the stomach.
The diagnosis of "peripheral lymphoma" doctors put quite rarely, if they can not carry the pathology to a particular kind. Peripheral lymphoma is characterized by acute (aggressive) course with the formation of metastases to other organs.
- Angioimmunoblastic T-cell lymphoma.
Its characteristic feature is the formation in the lymph nodes of seals with an infiltrate in the form of immunoblasts and plasma cells. At the same time, the lymph node structure is erased, but a large number of pathological blood vessels form around it, provoking the appearance of new pathologies.
The disease has an acute course. Immediately there is an increase in various groups of lymph nodes, liver and spleen, there is a rash on the body and other symptoms of cancer. Plasma cells can be found in the blood.
- T-cell lymphoblastic lymphoma, reminiscent of its course of acute T-lymphoblastic leukemia.
T-lymphocytes of irregular structure are involved in the development of the tumor process. They do not have time to ripen, because they have an imperfect core, and in this connection they begin to quickly divide, forming the same structures of irregular shape.
This is a fairly rare pathology that has good enough predictions if the disease is seized before it affects the bone marrow system.
T-cell lymphomas of various species usually undergo four stages in their development:
- At the first stage of pathology, there is an increase in only one lymph node or lymph nodes of one group.
- The second stage is characterized by an increase in the lymph nodes of different groups located on one side of the diaphragm.
- The third stage of the disease is said to be if the lymph nodes are enlarged on both sides of the diaphragm, indicating a spread of the malignant process.
- The fourth stage is the spread of metastases. Cancer affects not only the lymphatic system and skin, but also extends to internal organs (kidneys, lungs, liver, organs of the gastrointestinal tract, bone marrow, etc.).
Thus, the sooner lymphoma is detected, the more chances a person has to cope with the disease. At the 4th stage, these chances are practically reduced to zero.
T-cell mediastinal lymphoma
The number of cancers, sadly, tends to grow. Every year, oncological clinics are replenished with an increasing number of patients, including the lion's share of those diagnosed with mediastinal T-cell lymphoma.
For those who are not completely familiar with medical terminology and human anatomy, we explain that the mediastinum is not one of the organs, it is the area between the sternum and the spine, where all the organs of the thorax (esophagus, bronchi, lungs, heart, thymus gland, pleura, a lot of nerves and vessels).
If uncontrolled division of T-lymphocytes leads to the development of a tumor on one of the organs of the chest, they speak of lymphoma of the mediastinum. Its danger lies in the fact that the process can quickly spread to other organs. After all, cancer cells move calmly through the lymphatic system, which is washing various organs (including those affected by the disease) at least within one group of lymph nodes and further.
Symptoms of mediastinal lymphoma in general are characteristic of all oncological pathologies (weakness, nausea, weight loss, the appearance of dyspnea, etc.). A specific symptom, indicating the localization of the pathological process, is an increase in lymph nodes in and around the thorax (neck, axilla, groin, abdomen). What is important, when pressing on the swollen lymph nodes of pain, the patient does not feel that it speaks not of the inflammatory, but of the malignant process in them.
In its current, the T-lymphoma of the mediastinum passes not even 4 but 5 stages:
- Occurrence of several suspicious spots on the skin
- The number of skin lesions increases, but the lymph nodes remain unchanged
- In the area of spots appear swelling,
- Spots begin to inflame and blush,
- The process extends into the organs of the mediastinum region.
T-cell mediastinal lymphoma is most often diagnosed in middle-aged and elderly people, and in the latter it is more difficult, quite quickly giving metastases throughout the body.
A variety of T-cell lymphomas of the skin
A feature of this type of lymphoma is that uncontrolled proliferation of cells originates not in lymph nodes and organs, but in the skin, from where the process spreads into the body. Among cutaneous T-cell lymphomas there can be both fast-growing (aggressive) subspecies and species with sluggish flow.
To aggressive lymphomas that quickly start metastases to other organs and glands, doctors say:
- Cesary syndrome, which belongs to the category of pathologies, in which the level of eosinophils rises in the blood. Three symptoms are always present: erythroderma (reddening of the skin with lamellar scaling, extensive red rashes), lymphadenopathy (enlarged lymph nodes), and the presence of specific cells with folded nuclei in the blood that are found during laboratory tests and biopsy.
- T-cell leukemia-adult lymphoma is a tumor on the skin caused by retrovirus HTLV-1. Symptoms: defeat of the skin and lymph nodes, enlarged liver and spleen (hepatosplenomegaly), complete, unremovable bone resorption due to metastasis (osteolysis).
- Nasal type of extranodal T-cell lymphoma (polymorphic reticulosis). It develops from NK-like T. Leukocytes of irregular shape. The skin, upper parts of the respiratory tract (bronchi, trachea, lungs) and the gastrointestinal tract, the middle structures of the skull in the facial area (sky, nose, some parts of the central nervous system) are affected. Lesions of the skin in the form of seals (plaques) brownish-blue color are already observed on the 3 stages of the disease.
- Peripheral, unspecified T-cell lymphoma of the skin. Characterized by the appearance of lesions in the epidermal layers and an increase in lymph nodes, in the aftermath the process can spread into the body.
- Primary cutaneous aggressive epidermotropnaya CD8 + T - cell lymphoma. On the skin formed polymorphic elements (nodules, plaques, spots), often having ulceration in the center. Infiltration can also be found in the lungs, testicles in men, mucous membranes, CNS.
- Cutaneous γ / δ T - cell lymphoma, in which necrotic nodules and tumors appear mainly on the limbs, sometimes on mucous membranes. Bone marrow, lymph nodes and spleen rarely suffer.
This is an incomplete list of fast-growing lymphomas, the lifespan of patients with no more than 2 years. Rapid development is more typical of peripheral lymphomas. Most likely this is due to the fact that the movement of lymph is directed from the periphery to the center, which means that "sick" leukocytes are quickly delivered to different internal organs, where they can settle and accelerate to reproduce.
Sluggish flow of the process is observed in pathologies such as:
- Mushroom mycosis, which many patients do not even associate with a cancerous tumor because of its similarity with some dermatological pathologies. Symptoms: the appearance on the skin of plaques of various shapes and sizes (sometimes covered with scales and itchy, which resemble psoriasis), which gradually increase in size and turn into a tumor. In addition, there are swellings on the skin, enlarged lymph nodes, thickening of the skin on the palms and soles (hyperkeratosis), hair loss, deterioration of the nails, swollen eyelids, liver and spleen.
- Primary anaplastic T-cell lymphoma, which is one of the subspecies of pathology with the generalized name "large-cell lymphoma". It is characterized by the appearance on the skin of scarlet-red nodules of various sizes (1-10 cm). This can be a single rash, but quite often there is a large number of nodules.
- Panniculitis-like T-cell lymphoma is subcutaneous. Tumor process begins in the subcutaneous tissue. Symptoms: an increase in the blood of eosinophils, itching and rashes on the skin, constant fever, enlarged liver and spleen, an increase in lymph nodes, jaundice, edematous syndrome, weight loss.
- Primary cutaneous CD4 + pleomorphic T-cell lymphoma. The infiltrate consists of small and large cells. Eruptions in the form of plaques and knots can be seen on the face, neck and upper body.
These and some other subspecies of cutaneous T-cell lymphoma allow you to live with a disease of 5 or more years.
Complications and consequences
As for T-cell tumor pathologies, which are classified as malignant non-Hodgkin's lymphomas, then it is not so much the pathology itself that is scary as its complications. In the early stages, T-cell lymphoma affects only the skin and lymphatic system, which is manifested by a slight malaise. But the increase in the tumor in size and metastasis to other organs gradually disrupts the work of the whole organism, which leads to the death of patients.
A strongly enlarged lymph node can squeeze the upper vena cava providing blood flow to the heart, esophagus and digestive tract, respiratory, urinary and biliary tract, restricting the movement of liquids, air, food. The compression of the spinal cord leads to pain and a disturbance in the sensitivity of the limbs, which affects their activity.
Cancer cells on the lymphatic system can spread to the bone, brain and spinal cord, bones, liver and other organs, washed by lymph, passing around one of the groups of lymph nodes. The tumor increases the organ in size, reducing the internal volume or destroying the structure, which necessarily affects its functionality.
The disintegration of a large number of tumor cells leads to intoxication of the body with an increase in temperature, weakness, disruption of the joints due to the accumulation of uric acid in them (formed as a result of the decomposition of the cell nucleus).
Any cancer disease occurs against the background of a general decrease in immunity, which makes it possible to freely enter the body of an infection of various kinds (bacteria, viruses, fungus). Thus, lymphoma can be complicated by infectious diseases.
The consequences of T-cell lymphomas depend on the degree of malignancy of the process, the rate of its spread, the accuracy of the diagnosis and the timeliness of the treatment.
Diagnostics of the t-cell lymphoma
Despite the similarity of many types of T-cell lymphoma, the features of their course and approaches to their treatment can be different. And this means that the doctor needs to take the diagnosis of the disease especially carefully, in order to accurately determine its appearance, stage of development and develop a strategy for combating the terrible disease.
Diagnosis of T-cell lymphoma, as usual, begins with an examination by an oncologist. It is very important to tell the doctor about all the symptoms and the time of their onset. This is needed to accurately determine the stage of the disease and its prognosis. It is worth mentioning about cases of oncological diseases in the genus.
During the admission the doctor makes palpation of enlarged lymph nodes and determine the degree of their soreness. With cancer pathologies, lymph nodes are painless.
The patient is then referred for analysis. Initially, a blood test (general and biochemical) and urinalysis are performed that can detect the presence of inflammatory processes in the body, changes in the concentration of various blood components (eg, eosinophil increase), the presence of foreign or modified components, toxic substances.
Additionally, an immunological examination of the blood is performed. If such an analysis shows too little of IgG, there is a high probability of talking about a malignant tumor process in the lymphatic system. The analysis of blood for antibodies can show the presence in the body of viruses that can provoke the development of lymphoma.
Alternatively, in a private clinic, you can undergo a complex molecular genetic study that includes blood and urine tests, PRC analysis, hormone, infection, virus, etc., or even better oncoscreening of the body.
Further, with skin pathologies, scraping is taken from the affected area, and with increasing lymph nodes or suspected damage to the internal organs, a puncture biopsy is performed. The resulting material is sent for cytological analysis.
Instrumental diagnosis of T-cell lymphoma includes:
- Radiograph,
- A computer and magnetic resonance tomogram that allows you to see the state of the body from within in different angles.
- Ultrasound of the abdominal cavity with suspicion of mediastinal lymphoma.
- Scintigraphy for the detection of metastases and lesions of bone tissue.
- Computerized axial tomography.
Depending on the type of T-cell lymphoma and its stage, the oncologist doctor chooses the current methods of diagnosing the disease.
Differential diagnosis
Differential diagnosis is an important point in establishing an accurate diagnosis, especially with skin lymphomas, in many ways reminiscent of dermatological pathologies (eg, eczema, psoriasis, dermatitis), and pathologies accompanied by lymphadenopathy. The last moment is very important, since the increase in lymph nodes can be both malignant (with lymphomas) and benign (in inflammatory processes in the body).
Treatment of the t-cell lymphoma
Oncological pathologies have never been considered easy in therapy, but T-cell lymphoma, despite all the danger of the situation, is not an excuse to give up. The scheme and, to a large extent, the outcome of treatment always depends on the timeliness of antitumor activities and the type of T-cell pathology.
The main methods of combating malignant lymphatic neoplasms are:
- Systemic therapy with chemical drugs that stop tumor growth (chemotherapy).
- The effect on the tumor of ionizing radiation (electron beam therapy, which is the only method of physiotherapeutic treatment for malignant lymphomas).
- Admission corticosteroids (anti-inflammatory therapy),
- Reception of drugs that activate antitumor processes in the body (biotherapy). Preparations are made directly from the patient's cellular structures.
- Bone marrow transplantation. First, intensive chemotherapy (myeloablative therapy) is aimed at the complete destruction of cancer cells and suppression of the immune system in order to avoid rejection of the transplant, and then the patient is injected with healthy stem cells from the donor or their own taken before chemotherapy.
- Taking medications that stimulate the immune system, and vitamins to increase immunity.
- Surgery. Surgical removal of the tumor is performed only with single lesions, mainly when the tumor process is diagnosed in the gastrointestinal tract. To avoid recurrence of the tumor after its removal, chemotherapy is indicated simultaneously with several antitumor drugs (polychemotherapy).
Surgical treatment for T-cell lymphoma is not always justified. Firstly, in most cases, lesions are found a few, and the migration of pathological cells through the lymphatic system contributes to a fairly rapid spread of the disease to other organs (metastasis), which sometimes requires not one but several operations. And if you consider that cancer significantly weakens the body, then not every patient can tolerate even one, not that several surgical interventions.
The approach to treatment, of course, can be different depending on the localization and prevalence of the process. So for the treatment of a mild form of fungal mycosis (erythematous), the appointment of corticosteroids and interferon preparations is indicated. Chemotherapy is not prescribed, irradiation is not carried out.
In other forms of T-cell cutaneous lymphomas, both systemic and local treatment may be prescribed. Local treatment of skin cancer T-pathologies can be carried out with a preparation in the form of gel "Valhlor" produced in the USA. Alas, this drug is still not available in our country.
The active substance of the drug is mechlorethamine. Preparations with this active substance (for example, "Embichin") are used for systemic therapy of T-cell forms of skin cancer. Also, anti-tumor agents such as Vinblastine, Fludarabine, Dakarbazine, Chlorbutin, Adriamycin, Vincristine, Cyclophosphane and others can be used as part of polychemotherapy.
In skin pathologies, antitumor antibiotics (for example, Rubomycin), corticosteroids (for example, Prednisolone, Triamcinolone) and phototherapy (more often PUVA therapy) are also used.
In the biotherapy of T-cell lymphomas, both patient cell preparations and monoclonal antibodies in the form of Rituxan, Mabtera, Kampas, Kampat, Avastin, Beksar can be used.
The treatment of the consequences of high-dose myeloablative therapy is carried out with the use of preparations "Filstim", "Zarsio", "Neipomax", etc.
Drugs can be administered either orally or intravenously. Most drugs are designed for drip administration. Treatment should be carried out under the strict supervision of an oncologist.
Radiation therapy with T-cell lymphoma is usually conducted in a course of 21-40 days. Irradiation is local in nature, without damaging the rest of the body. Time and radiation dose is determined by the radiologist, depending on the location and stage of the tumor process.
At the initial stages of pathology, radiation therapy can be prescribed as an independent method of treatment, then it is already used in combination with chemotherapy.
With glowing forms of T-lymphoma, doctors are slow to prescribe conservative treatment, taking a wait-and-see attitude. The patient is regularly observed in the oncologist, and in case of an exacerbation he will be assigned effective therapy in accordance with the type of pathology.
Drugs for T-cell lymphoma
It is worth mentioning immediately that the treatment of cancer of any etiology is a serious issue that specialists must deal with. What kinds of drugs will be effective for a particular pathology, and what kind of treatment scheme to apply, the specialist doctor decides. Doctors categorically do not recommend self-treatment.
There are quite a few drugs for the treatment of tumoral diseases today. If we talk about their effectiveness, it is worth noting: the timely initiation of therapy in most cases gives positive results. It is clear that the advanced stages of cancer are beyond the power even of chemotherapy. In addition, each organism is individual, and what brings the desired relief to one does not always help save the life of another patient.
Consider only a few drugs that doctors use to treat T-cell lymphomas of various origins.
"Embichin" is an alkylating cytotoxic drug, whose action is directed to the destruction of the cell structure of clones of T-lymphocytes with gene mutations.
Enter the drug intravenously according to one of the two schemes:
- The shock method is designed for a 4-day course of chemotherapy. Daily, once a day, the patient is given the drug in a dosage determined as 0.1 mg per kilogram of body weight. Sometimes prescribe the drug in full dosage once.
- Fractional-traction method. The medicine is administered 3 times a week. The usual dosage is 5-6 mg. Course - from 8 to 20 introductions.
Possible introduction into the pleural and abdominal cavities.
The drug is not prescribed for a complicated course of the disease, with severe anemia, certain blood diseases (leukopenia and thrombocytopenia). The question of the possibility of using the drug will also arise in case of severe damage to the kidneys and liver, as well as in cardiovascular pathologies.
Among the frequent side effects can be distinguished changes in the characteristics of the blood, symptoms of anemia, disruption of the digestive tract, sometimes weakness and pain in the head. If the drug enters the skin during injection, it can cause the formation of infiltration and tissue necrosis at the site of administration. The severity of the major side effects with intensive therapy is much stronger than with the fractional administration of the drug.
"Vinblastine" is an antineoplastic drug based on vinca alkaloid. Has antitumor effect due to the fact that it blocks the division of cells.
The drug can be administered only intravenously, trying to avoid getting under the skin. The dose is selected in accordance with the chosen chemotherapy regimen. The standard dosage is from 5.5 to 7.4 mg per square meter of body surface area (infant dose from 3.75 to 5 mg per square meter). The drug is prescribed 1 time a week, sometimes 1 time in 2 weeks.
There is another scheme of administration, in which they start treatment with a minimal infant dose, gradually increasing it to 18.5 mg per 1 sq.m. Body. For children, the initial dose is 2.5, and the maximum dose is 12.5 mg per 1 sq. M.
The course of treatment depends on the white blood cell count.
The drug is not used for severe oppression of bone marrow function, infectious pathologies, during pregnancy and breastfeeding. Do not use medicine for hypersensitivity to its components.
Frequent side effects: leukopenia and granulocytopenia. Disorders from other organs and systems are much less common.
"Rubomycin" - a drug that belongs to the category of antitumor antibacterial agents, i.e. He simultaneously fights both cancerous and bacterial cells.
The drug is also administered intravenously to avoid the appearance of infiltration and death of skin tissues. Assign the drug course in 5 days, during which the patient receives the drug at a dosage of 0.8 mg per 1 kg of body weight. Repeat the course after 7-10 days. Now the drug is prescribed for a period of 3 to 5 days at a dosage of 0.5-1 mg per kg of body weight per day. Pediatric dose - from 1 to 1.5 mg per 1 kg of weight per day.
There are many cancer treatment regimens using the drug in combination with other antitumour agents, in which the dosage and the frequency of reception may vary.
Contraindications to the use of the drug are severe pathologies of the heart, blood vessels, liver and kidneys, suppression of bone marrow function, pregnancy and lactation. At acute infectious pathologies there is a risk of development of various complications. It is forbidden to drink alcohol.
The most common side effects are granulocytopenia and trobrocytopenia (a decrease in the concentration of granulocytes and platelets in the blood).
"Campas" is a drug based on monoclonal antibodies that bind to lymphocytes and dissolve them, while the bone marrow stem cells remain unaffected, so the production of T lymphocytes does not suffer. Mature and lymphocytes already matured.
The drug is injected into the body by infusion, while the process of intravenous infusion is long and is at least 2 hours. To avoid allergic reactions and painful sensations, before the dropper, analgesics and antihistamines are taken.
The drug for 3 days is introduced according to the scheme with increasing dosage: 3, 10 and 30 mg, while constantly monitoring the reaction of the body to the drug. Next, the drug is administered every other day for 1-3 months. Dosage at the same time remains maximum - 30 mg per day.
With a poor tolerance of the drug with the occurrence of side effects, the dose is gradually increased only after the reaction to the drug has returned to normal.
The drug is prohibited in patients with acute stage of infectious pathology of a systemic nature, including cases of HIV infection, non-lymphocytic tumors, during pregnancy and during breastfeeding, with hypersensitivity to components. The drug is canceled if there are toxic reactions or there is further progression of the disease.
There is insufficient information about the effect of the drug on the children's body.
The most common side effects of the drug are: chills, fever, increased fatigue, lower blood pressure, headaches. Many of them have GIT reactions in the form of nausea, sometimes with vomiting, and diarrhea, changes in blood composition (reduced granulocyte and platelet count, anemia), hyperhidrosis, allergic reactions. It can also develop sepsis, herpes simplex, pneumonia. Quite often patients note a feeling of lack of air (dyspnoea).
"Nejpomaks" - a drug that stimulates the production of leukocytes, the active substance - filgrastim.
The introduction of large doses of chemotherapeutic agents before bone marrow transplantation often leads to a decrease in the production of leukocytes, which must be corrected before the procedure begins. The same phenomenon can be observed after usual chemotherapy. Therefore, patients with neutropenia (insufficient production of neutrophilic leukocytes) and prescribe drugs based on filgrastim.
The medication is prescribed one day after the chemotherapy in a dosage of 5 μg per day. Enter the drug subcutaneously. The course of treatment is not more than 14 days. Therapy is continued until the optimal number of neutrophils in the blood is reached.
With myeloablative therapy, the drug is prescribed in a dosage of 10 μg for 4 weeks. Enter it intravenously drip.
The drug is not used for severe congenital neutropenia (Kastmann syndrome) and hypersensitivity to the components of the drug. Caution is observed with sickle cell anemia.
Among the side effects of the drug can be identified: dyspeptic phenomena, myalgia and arthralgia, increased liver and spleen sizes, the appearance of infiltrate in the lungs, bronchial spasms and dyspnea. Also, sometimes there is a decrease in bone density, a jump in blood pressure, an increase in heart rate, swelling on the face, nosebleeds, weakness. In some cases, changes in the blood composition are observed: a decrease in the platelet count and an increase in the white blood cell count (thrombocytopenia and leukocytosis). In the urine, protein and blood (protein and hematuria) can be detected.
Non-traditional methods of cancer treatment
It would seem that effective methods of combating cancer exist (the same radiation and chemotherapy), and medicines that can kill the cells are enough, but not everyone can afford this treatment. In addition, the methods of traditional medicine leave behind many new problems, which again have to be treated.
For example, the effects of chemotherapy can be seen in the form of alopecia (active hair loss), weight gain due to increased appetite, heart rhythm disturbances and the development of heart failure. In some cases, a new diagnosis (usually another type of blood cancer) is attached to the diagnosis. For men, chemotherapy may threaten the inability to have children (infertility).
Cases of complications after radiation therapy are also common. It can be a decrease in the functionality of the thyroid gland (as a rule, hypothyroidism develops), the development of radiation pneumonitis characterized by cicatricial structures in the lung tissues, inflammation of the intestine or bladder (colitis and cystitis), inadequate saliva production, and radiation burns.
It turns out, one treats - the other is crippled. This moment and the high cost of therapy of T-cell lymphoma and other oncological pathologies push people to search for new and new methods of treating a terrible disease.
On the Internet, you can now find many posts about the treatment of cancer using non-traditional methods. Someone rejects alternative treatment, referring to the fact that it did not save life for acquaintances, others actively use it, achieving good results. We will not take either side, but only give a little information about the medicines used outside the oncological hospital.
Many adherents of non-traditional cancer treatment (including many doctors!) Agree on the opinion that the development of malignant tumors is caused by the acidic environment of the body, in which there is not enough oxygen for the normal functioning of cells. If the pH level of the internal environment is raised, cellular respiration improves, and cell proliferation stops. It turns out that products that reduce the acidity of the body and improve the supply of cells with oxygen, can stop the development of malignant processes.
A special role in this regard is given to the product that is actually present in every kitchen - baking soda. As alkali it is able to reduce the acidity of any medium, including the internal environment of the body. Soda is recommended for use as a peroral (alkalizing the gastrointestinal tract, getting in some quantity and into the blood), and in the form of injections, which allows you to deliver alkali to all corners of the body through the blood. However, pre-soda is recommended to extinguish with boiling water.
According to the method of the Italian doctor (!) Tulio Simoncini, soda should be taken twice a day half an hour before meals (gradually increasing the dose from 1/5 to 2 tsp), diluting it with hot water and washing down a glass of liquid (water, milk). It is necessary that the soda solution contacts directly with cancer cells, therefore, for the treatment of various types of cancer, lotions, inhalations, injections, douchings are also used.
One of the adherents of this method of cancer treatment is our compatriot professor Ivan Pavlovich Neumyvakin, who developed a system for treating various types of cancer with the help of soda and hydrogen peroxide. In this case, not pure peroxide is used, but its solution (from 1 to 10 drops of 3% hydrogen peroxide is taken for 50 ml of water). Take the drug three times a day for an hour before a meal, every day increasing the number of drops peroxide per 1 (the first day - 1 drop, the second - two, etc.). After 10 days of treatment, make a 5-day break.
By the way, in order to reduce the acidity of the internal environment and block the way of cancer, scientists adherents of alkalizing the body advise paying special attention to their food, because in our diet there are products that can either increase or lower the pH. The alkalizing products include herbs, fruits (except very sweet), dried apricots, almonds, milk and dairy products, berries, vegetables. But meat, sausages and smoked products, fish and seafood, eggs, pastries, grape juice, jam, preservation on the contrary increase the acidity of the body. By the way, a lemon without sugar is considered to be an alkaline product, despite its acid, but if used with sugar, its effect will be directly opposite.
Interest is caused by such a method of fighting cancer as drinking beet juice, which also improves cellular respiration and is able to arrest the growth and development of cancer cells. And if we take into account the rich vitamin-mineral composition of the bright red root, then we can say with certainty that treatment with it will help strengthen the immune, nervous and other body systems. And this will enable the body to independently fight various diseases, including cancer.
The intake of beet juice is perfectly combined with traditional methods of treatment and even reduces their negative consequences. But there is also information about curing cancer with beet juice alone, which is much cheaper than the course of treatment in the oncological hospital.
For treatment, a freshly squeezed juice that is kept in the refrigerator for at least 2 hours is used, made from the fruit of table varieties with a bright color. In order to get a sufficient antitumor result, you need to drink during the day, 600 ml of juice. Drink the juice should be slightly warmed for half an hour before eating. You can mix it with carrot juice.
Drink beet juice in small sips of 100 ml per 1 reception daily. The course of treatment is long (1 year or more). To stabilize the juice drink in the amount of 1 cup per day.
It is also useful to use boiled beets, because with a short heat treatment, it actually does not lose its useful properties.
By the way, the choice of alternative healers fell on the beet. Its antitumor properties are recognized and official medicine. On the basis of beet, one of the antitumor drugs has even been developed.
Many plants possess antitumoral properties, and let the treatment with herbs of T-cell lymphoma and other cancers not widely spread, there are positive responses and such treatment.
Even in official medicine, plants containing caryoclastic poisons capable of killing pathogenic cells are recognized as antitumor agents. Such poisons include alkaloids, lactones and cardiac glycosides found in many plants:
- alkaloid-containing: colchicum brilliant and gorgeous (tubers), celandine, barberry, rue, wormwood, yellow wool and some others,
- lactose-containing: podofil thyroid and Himalayan, eucommia, helenium, almond allegiance, gaylyardia.
- Containing cardiac glycosides: white, dioecious and chernoplodny, furious cucumber, colocynt, drug auran, etc.
It should be understood that the above plants contain poisonous substances, and therefore their dosage is strictly limited.
Anti-inflammatory and antitumor effect is also famous for the fruits of Japanese Sophora, radish seeds, clover, elder, and saber. And as immunomodulators for T-cell lymphoma, you can use extracts of ginseng, echinacea,, elleuterococcus. Do not lag behind them and such popular plants as nettles, calendula, plantain, dandelion, string.
As for homeopathy, it does not undertake to cure completely aggressive malignant tumors, but some of its remedies are quite suitable as additional and preventive. So, if after the traditional treatment of malignant lymphoma there are exacerbations. A homoeopathic doctor can prescribe a long-term intake of homeopathic preparations Barium carbonicum (5 granules under the tongue 2 times a day) and Conium (7 pellets before bedtime).
As antitumor drugs, Carcinosinum and Phytolyacca have proven themselves, and as an immunostimulant Echinacea compositum, Mucosa compositum, Edas-308, Galium-Hel and other homeopathic medicines are used.
Prevention
The issue of preventing the development of oncological pathologies with high mortality, including T-cell lymphoma, is quite complicated. To be honest, scientists still do not know the clear answer to the question: how to prevent the appearance of cancer.
If we consider those factors that increase the likelihood of development of oncological pathologies, it can be understood that not all of them can be excluded from their lives. People with hereditary predisposition and immunodeficiencies will have to exert a great deal of effort to avoid the fate of relatives with oncological diseases.
It should be understood that the risk of getting cancer lower in those people who cure inflammatory pathologies (including dermatological pathologies) in time, not allowing them to chronize, do not work with carcinogens, live in ecologically clean areas, do not undergo radiation exposure. Those. There is something to think about, because your life is at stake.
A huge role in the prevention of cancer is played by the treatment of conditions capable of passing into cancer (precancerous conditions). Scientists-phytotherapeutists even developed a plant harvest that prevents uncontrolled cell division. In its composition, we find: nettle leaves and psyllium 5 g each, flowers of a moth and birch earrings 10 g each, licorice (roots) in the amount of 3 g.
Thoroughly crushed raw materials are mixed, take 10 g of the composition and brew 1 tbsp. Boiling water, then it is kept in a water bath for about 20 minutes. After percolation, it turns out that the glass is incomplete. You need to top up it with boiled water.
The received infusion should be drunk daily 3 times a day. 1 cup of medication is enough for 1 day. You need to drink it half an hour before a meal for 1 or 2 months.
Whatever it was, but it is better to take all measures of cancer prevention than to fight fiercely for your life after hearing a terrible diagnosis.
Forecast
The prognosis of T-cell lymphoma is not at all iridescent, especially as regards its aggressive species, for which sometimes there is simply no time to fight. The earlier the disease is detected, the more likely it is to be defeated. If the disease is captured at the first stage of its development, the chances of surviving for another 5 or more years are 85-90%, depending on the type of pathology and age of the patient.
The worst is the prognosis for angioimmunoblastic and T-lymphoblastic lymphomas if the process has spread to the bone marrow and other organs. With angioimmunoblastic T-cell lymphoma, patients usually die after 2-3 years, and only slightly more than 30% live longer. Improvement in lymphoblastic complicated lymphoma can be observed only in a fifth of patients. Although if you start treatment of the disease at an early stage, the forecast in most cases is quite favorable.
As for mushroom mycosis, everything depends on the form and stage of pathology. The classical form is characterized by the best forecast. In time, the treatment started in the absence of complications can give patients another 10 or more years of life. With complicated pathologies, the life span is reduced to 2-5 years. But with the Vidal-Brok form, most patients die within one year.
T-cell lymphoma, like other cancer pathologies, feeds on our fear. Therefore, the prognosis for life largely depends on the patient's mood. In medical practice there were cases of "miraculous" healing, when people standing on the edge of the grave, which the doctors could not help, were recovering only because they believed in the possibility of victory over the deadly disease. No matter how circumstances develop, one should never give up, because life is the greatest value for a person, and it is worth fighting for.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
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