T-cell lymphoma: peripheral, angioimmunoblastic, non-Hodgkin's, anaplastic lymphoma

Cancer is considered one of the most dangerous human diseases. And if you also consider that several types of fatal disease that have cut short the lives of many people are hidden under the terrible diagnosis, then you will inevitably become interested in this issue in order to avoid a similar fate. Take, for example, one of the most dangerous types of blood cancer, affecting the lymphatic system and skin, which is called T-cell lymphoma. It is because of this pathology that many elderly people do not live to see their long-awaited pension or enjoy it for a very short time. Although, frankly speaking, not only old people should be included in the risk group for developing this pathology.

Epidemiology

As for the statistics of lymphomas, T-cell lymphoma occupies a prominent place among cancerous blood pathologies observed in the older age period. However, it can hardly be called a disease of old people, since cases of the disease have been repeatedly recorded even in children and adolescents. At the same time, men are more predisposed to the disease than women.

The epidermotropic nature of the pathology suggests that the disease is localized primarily in the skin, organ membranes and lymph nodes located in close proximity to them. The most common form of the disease is considered to be T-cell lymphoma of the skin, and in particular fungoid mycosis.

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Causes T-cell lymphoma

Lymphoma is a tumor formation consisting of modified cells of the lymphatic system. In the case of T-cell lymphoma, the participants in the pathological process are T-cells (T-lymphocytes), developing in the thymus gland from prethymocytes, which are contained in the red bone marrow, from where they migrate to the thymus.

T-lymphocytes are a factor that provides the body's immune response to various external influences and regulates the processes occurring inside it. Thus, any inflammatory process in the body causes redistribution of T-lymphocytes, which accumulate near the lesion along the lymph flow. After the inflammation is stopped, the lymph nodes acquire their original size and elasticity. Unfortunately, this does not always happen.

Scientists are not yet ready to give a full answer to the question of what causes the uncontrolled accumulation of lymphocytes in one point without any apparent reason, and what causes the mutation of lymphatic system cells, which begin to divide (proliferation) intensively, leading to unwanted tissue growth inside the body. Uncontrolled cell proliferation leads to an increase in the size of the lymph nodes and organs, to which the mutated T-lymphocytes are supplied. All this causes dangerous disruptions in the functioning of organs and glands, leading to the death of the patient.

Most scientists are inclined to believe that T-cell lymphoma is a consequence of an unspecified leukemia. Leukemia is characterized by the appearance of modified cells formed from immature hemocytoblasts of the bone marrow, which are the precursors of blood cells. In T-cell leukemia, mutations are observed in lymphoblasts and prothymocytes, the precursors of T-lymphocytes.

Such malignant clones from the red bone marrow can also enter the thymus, and from there, in the form of mutated T-lymphocytes prone to uncontrolled proliferation, and into the lymphatic system. Thus, T-cell leukemia type 1 (aka HTLV 1 – Human T-lymphotropic virus 1), which belongs to the family of retroviruses, becomes the most likely cause of the development of T-cell lymphoma.

However, this theory does not explain the malignization of mature T-lymphocytes, which were not initially pathogenic. It turns out that they experienced the negative influence of some factors other than the HTLV 1 virus, which led to mutations.

One of the theories of T-cell lymphoma formation is the hypothesis of the negative impact of certain viruses (for example, herpes viruses type 6 and type 4, hepatitis virus, HIV) on the quality of lymphocytes. These viruses are often found in patients with blood cancer, which means their influence cannot be ruled out.

Since the production of T-lymphocytes is controlled by the immune system, any discrepancy in its work can lead to increased production of T-lymphocytes from bone marrow cells that fail to mature and a greater likelihood of chromosomal mutation in them. An inadequate response of the immune system to irritants can also manifest itself in the form of an accumulation of rapidly dividing lymphocyte clones in the epithelial layers of the skin, leading to the formation of microabscesses, which is observed in T-cell lymphoma of the skin.

Simultaneously with the proliferation of lymphocytes, there is a decrease in the activity of cells that provide anti-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 interaction between cells, determine their lifespan, stimulate or inhibit cell growth, 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. A decrease in the activity of these molecules can open the way to the formation of tumors.

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Risk factors

Risk factors for the development of T-cell lymphoma include:

• 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 of a viral infection in the body (herpes viruses types 1, 4 and 8, hepatitis B and C viruses, lymphocytic virus, HIV infection and even Halicobacter pylori).
• Inadequate functioning of the immune system due to previously existing mutations and structural changes. We are talking about autoimmune pathologies, the introduction of immunosuppressants into the body that suppress the functioning of the immune system.
• Long-term contact with carcinogenic substances.
• Hereditary predisposition and congenital immunodeficiency states.
• Long-term exposure to ionizing and ultraviolet radiation, and certain chemicals that cause lymphocyte mutations.
• Chronic course of various types of dermatosis (psoriasis, atopic dermatitis, etc.), leading to prolonged presence of lymphocytes in the affected area, provoking a decrease in immunity and proliferation of malignant clones in the local area. This can lead to the formation of a malignant process on the skin.
• Advanced age.

Most often, the development of the disease is not caused by one reason, but by the combined effect of several factors. This may be why specific manifestations of the disease are observed mainly in adulthood, after the body has been negatively affected by many factors for a long time.

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Symptoms T-cell lymphoma

When talking about the symptoms of the disease, it is important to understand that the variety of types of T-cell lymphoma will leave its mark on the clinical picture of the disease in each specific case. However, there are some common signs that are characteristic of many oncological pathologies.

The first, albeit non-specific, signs of the development of the disease are considered to be:

• causeless loss of appetite, disruption of the digestive process,
• weight loss, despite the fact that the quantity and caloric content of food did not undergo significant changes,
• chronic weakness, decreased performance,
• apathy towards what is happening around,
• increased reaction to stress factors,
• increased sweating (hyperhidrosis), especially at night,
• constant slightly elevated temperature (subfebrile temperature readings are within the range of 37-37.5 degrees),
• chronic constipation, if the tumor is localized in the pelvic area,

Specific symptoms of T-cell lymphoma include:

• persistent enlargement and hardening of the lymph nodes,
• an increase in the size of internal organs (most often the liver and spleen),
• redness and burning of the skin, the appearance of rapidly growing lesions in the form of ulcers, plaques, papules,
• disruption of the structure (destruction) of bone tissue.

Forms

The disease can have different courses, which is why the following forms of pathology are distinguished:

• Acute form.

It is characterized by rapid development of the disease. From the appearance of the first signs to the full disclosure of all symptoms, no more than 2 weeks pass. Such a course of the disease is observed in more than half of all patients diagnosed with T-cell lymphoma.

Enlargement of lymph nodes is usually absent in this form of pathology. Death occurs within six months from the onset of the disease from complications such as pneumonia, infection in the affected areas of the skin, destruction of bones with poisoning of the body with decay products, decreased immunity, leptomeningitis with mental disorders, etc.

• Lymphomatous form.

Similar to the above-mentioned in clinical picture. However, one of the symptoms of the pathology is enlarged lymph nodes. This course of the disease is observed in a fifth of patients.

• Chronic form.

The clinical picture takes a longer time to fully develop and is less pronounced. The nervous, digestive and skeletal systems are not affected unless the disease becomes acute. Patients live with the pathology for about 2 years.

• Smoldering form.

The rarest form of the disease, characteristic of 5 patients out of 100. A small number of mutated T-lymphocytes is noted, proliferation occurs more slowly than in other forms of lymphoma. Nevertheless, symptoms of damage to the skin and lungs are noticeable. Life expectancy of patients is about 5 years.

We will talk in more detail about the manifestations of T-cell lymphoma, examining various types of pathology and the characteristics of their course.

Since T-cell lymphomas can differ not only in the location of the pathological process, but also in external manifestations and the mechanism of formation, it is customary to classify them into the following types:

• Cutaneous T-cell lymphoma.

The cause of the emergence of such neoplasms is considered to be mutations of mature T-lymphocytes under the influence of unfavorable factors (viruses, radiation, burns), as a result of which they gain the ability to actively multiply and form clusters of mutated clones in the epidermal layer.

Clinical picture: the appearance of various rashes on the skin (plaques, blisters, spots, papules, etc.).

The pathology usually occurs in 3 stages. At the beginning of the disease, patients note the appearance of eczema-like spots that begin to itch and peel, then plaque-like formations appear in their place, gradually growing and rising above the surface of the body. Then, mutant clones circulating through the lymphatic system join the "wrong" lymphocytes in the skin, the cancer metastasizes, which leads to the death of the patient within 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 that provide an anti-tumor effect). Only mature cells prone to excessive proliferation are involved in the process. Such lymphomas can form in lymph nodes and on internal organs near the affected lymph nodes. They affect the quality of blood, the condition of the skin and bone marrow, and lead to the destruction of bone tissue.

Clinical picture: enlarged lymph nodes in the neck, groin and armpits. This type of pathology is characterized by non-specific symptoms of the disease described above, plus some unpleasant manifestations associated with enlarged organs (usually the liver and spleen). Patients note the appearance of breathing difficulties, recurring causeless cough, heaviness in the stomach.

Doctors rarely diagnose "peripheral lymphoma" if they cannot classify the pathology as a specific type. Peripheral lymphoma is characterized by an acute (aggressive) course with the formation of metastases to other organs.

• Angioimmunoblastic T-cell lymphoma.

Its characteristic feature is the formation of seals in the lymph nodes with an infiltrate in the form of immunoblasts and plasma cells. In this case, the structure of the lymph node is erased, but a large number of pathological blood vessels are formed around it, provoking the emergence of new pathologies.

The disease has an acute course. Immediately there is an increase in various groups of lymph nodes, liver and spleen, a rash on the body and other symptoms of cancer appear. Plasma cells can be found in the blood.

• T-cell lymphoblastic lymphoma, which resembles acute T-lymphoblastic leukemia in its course.

T-lymphocytes of irregular structure take part in the development of the tumor process. They do not have time to mature, therefore they have an imperfect nucleus, and therefore they begin to divide quickly, forming the same irregular structures.

This is a fairly rare pathology that has a fairly good prognosis if the disease is caught before it affects the bone marrow system.

T-cell lymphomas of various types usually go through 4 stages in their development:

1. At the first stage of the pathology, an increase in only one lymph node or lymph nodes of one group is observed.
2. The second stage is characterized by an increase in lymph nodes of different groups located on one side of the diaphragm.
3. The third stage of the disease is indicated when the lymph nodes are enlarged on both sides of the diaphragm, which indicates the spread of the malignant process.
4. The fourth stage is the spread of metastases. Cancer affects not only the lymphatic system and skin, but also spreads to internal organs (kidneys, lungs, liver, gastrointestinal tract, bone marrow, etc.).

Thus, the earlier lymphoma is detected, the greater the chances of a person to cope with the disease. At stage 4, these chances are practically reduced to zero.

Mediastinal T-cell lymphoma

The number of cancer cases, sadly, tends to grow. Every year, oncology clinics are filled with more and more patients, among whom the lion's share of those diagnosed with mediastinal T-cell lymphoma.

For those who are not quite familiar with medical terminology and human anatomy, we will 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 chest are located (esophagus, bronchi, lungs, heart, thymus gland, pleura, many nerves and vessels).

If uncontrolled division of T-lymphocytes leads to the development of a tumor in one of the organs of the chest, it is called mediastinal lymphoma. Its danger lies in the fact that the process can quickly spread to other organs. After all, cancer cells easily move along the lymphatic system, washing various organs (including those affected by the disease) at least within one group of lymph nodes and further.

Symptoms of mediastinal lymphoma are generally typical of all oncological pathologies (weakness, nausea, weight loss, shortness of breath, etc.). A specific symptom indicating the localization of the pathological process is an increase in lymph nodes in the chest and around it (neck, armpits, groin, abdomen). What is important is that when pressing on the swollen lymph nodes, the patient does not feel pain, which indicates not an inflammatory process, but a malignant process in them.

In its course, mediastinal T-lymphoma goes through not even 4, but 5 stages:

1. The appearance of several suspicious spots on the skin
2. The number of skin lesions increases, but the lymph nodes remain unchanged
3. Swelling appears in the area of the spots,
4. The spots begin to become inflamed and red,
5. The process spreads inward to the organs of the mediastinal region.

Mediastinal T-cell lymphoma is most often diagnosed in middle-aged and elderly people, and in the latter it is more severe, quickly metastasizing throughout the body.

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Diversity of cutaneous T-cell lymphomas

The peculiarity of this type of lymphoma is that uncontrolled cell proliferation originates not in the lymph nodes and organs, but in the skin, from where the process spreads into the body. Among cutaneous T-cell lymphomas, there may be both fast-growing (aggressive) subtypes and varieties with a sluggish course.

Doctors classify the following as aggressive lymphomas that quickly metastasize to other organs and glands:

• Sezary syndrome, which is a pathology in which the level of eosinophils in the blood increases. In this case, 3 symptoms are necessarily present: erythroderma (reddening of the skin with lamellar peeling, extensive red rashes), lymphadenopathy (enlarged lymph nodes) and the presence of specific cells with folded nuclei in the blood, which are detected during laboratory tests and biopsy.
• Adult T-cell leukemia-lymphoma is a skin tumor caused by the retrovirus HTLV-1. Symptoms: skin and lymph node lesions, enlargement of the liver and spleen (hepatosplenomegaly), complete, uncompensated resorption of bone tissue due to metastasis (osteolysis).
• Nasal type of extranodal T-cell lymphoma (polymorphic reticulosis). Develops from NK-like T. leukocytes of irregular shape. Affects the skin, upper respiratory tract (bronchi, trachea, lungs) and gastrointestinal tract, mid-skull structures in the facial area (palate, nose, some parts of the central nervous system). Skin lesions in the form of seals (plaques) of brownish-blue color are observed already at stage 3 of the disease.
• Peripheral unspecified T-cell lymphoma of the skin. Characterized by the appearance of lesions in the epidermal layers and enlargement of the lymph nodes, subsequently the process can spread deep into the body.
• Primary cutaneous aggressive epidermotropic CD8+ T-cell lymphoma. Polymorphic elements (nodules, plaques, spots) are formed on the skin, often with ulcerations in the center. The infiltrate can also be found in the lungs, testicles in men, mucous membranes, and the central nervous system.
• Cutaneous γ/δ T-cell lymphoma, in which necrotic nodules and tumors appear mainly on the extremities, sometimes on the mucous membranes. Bone marrow, lymph nodes and spleen are rarely affected.

This is an incomplete list of fast-growing lymphomas, the life expectancy of patients with which is no more than 2 years. Rapid development is more typical for 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 various internal organs, where they can settle and multiply rapidly.

A sluggish progression of the process is observed in such pathologies as:

• Mycosis fungoides, which many patients do not even associate with a cancerous tumor due to its similarity to some dermatological pathologies. Symptoms: the appearance of plaques of various shapes and sizes on the skin (sometimes covered with scales and itchy, which resemble psoriasis), which gradually increase in size and turn into a tumor. In addition, there are swelling of the skin, enlarged lymph nodes (lymphadenopathy), thickening of the skin on the palms and soles (hyperkeratosis), hair loss, deterioration of the nails, swelling and eversion of the eyelids, enlarged liver and spleen.
• Primary anaplastic T-cell lymphoma, which is one of the subtypes of the pathology with the general name "large cell lymphoma". It is characterized by the appearance of purple-red nodules of various sizes (1-10 cm) on the skin. These can be single rashes, but the appearance of a large number of nodules is also quite common.
• Panniculitis-like T-cell lymphoma subcutaneous. The tumor process begins in the subcutaneous tissue. Symptoms: increased eosinophils in the blood, itching and rashes on the skin, constant fever, enlarged liver and spleen, enlarged lymph nodes, jaundice, edema syndrome, weight loss.
• Primary cutaneous CD4+ pleomorphic T-cell lymphoma. The infiltrate consists of small and large cells. Plaque and nodular lesions can be seen on the face, neck, and upper torso.

These and some other subtypes of cutaneous T-cell lymphoma allow you to live with the disease for 5 years or more.

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Complications and consequences

As for T-cell tumor pathologies, which are classified as malignant non-Hodgkin's lymphomas, it is not so much the pathology itself that is scary, but its complications. In the early stages, T-cell lymphoma affects only the skin and lymphatic system, which is manifested by minor discomfort. But the increase in tumor size and metastasis to other organs gradually disrupts the functioning of the entire body, which leads to the death of patients.

A greatly enlarged lymph node can compress the superior vena cava, which supplies blood to the heart, the esophagus and digestive tract, the respiratory, urinary and biliary tracts, limiting the movement of fluids, air, and food through them. Compression of the spinal cord leads to pain and impaired sensitivity of the limbs, which affects their activity.

Cancer cells can spread through the lymphatic system to the bone, brain, spinal marrow, bones, liver, and other organs washed by lymph passing through one of the lymph node groups. The tumor increases the size of the organ, reducing its internal volume or destroying its structure, which necessarily affects its functionality.

The breakdown of a large number of tumor cells leads to intoxication of the body with an increase in temperature, weakness, and disruption of joint function due to the accumulation of uric acid in them (formed as a result of the decomposition of the cell nucleus).

Any oncological disease occurs against the background of a general decrease in immunity, which allows various types of infections (bacteria, viruses, fungi) to freely penetrate the body. 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 treatment.

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Diagnostics T-cell lymphoma

Despite the similarity between many types of T-cell lymphoma, the features of their progression and approaches to their treatment may be different. This means that the doctor must approach the diagnosis of the disease especially carefully in order to accurately determine its type, stage of development and develop a strategy to combat 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 appearance. This is necessary to accurately determine the stage of the disease and its prognosis. It is also worth mentioning cases of oncological diseases in the family.

During the appointment, the doctor palpates the enlarged lymph nodes and determines the degree of their pain. In cancer pathologies, the lymph nodes are painless.

The patient is then referred for tests. Initially, a referral is given for a blood test (general and biochemical) and a urine test, which allow the detection of inflammatory processes in the body, changes in the concentration of various blood components (for example, an increase in eosinophils), the presence of foreign or modified components, and toxic substances.

Additionally, an immunological blood test is performed. If such an analysis shows too little IgG, there is a high probability of a malignant tumor process in the lymphatic system. A blood test for antibodies can show the presence of viruses in the body that can provoke the development of lymphoma.

As an option, in private clinics you can undergo a comprehensive molecular genetic study, which includes blood and urine tests, PCR analysis, testing for hormones, infections, viruses, etc., or even better, body cancer screening.

Next, in case of skin pathologies, a scraping is taken from the affected area, and in case of enlarged lymph nodes or suspicion of damage to internal organs, a puncture biopsy is performed. The obtained material is sent for cytological analysis.

Instrumental diagnostics of T-cell lymphoma includes:

• X-ray,
• Computer and magnetic resonance imaging, which allows you to see the state of the body from the inside from different angles.
• Ultrasound of the abdominal cavity for suspected mediastinal lymphoma.
• Scintigraphy for detection of metastases and bone tissue lesions.
• Computer axial tomography.

Depending on the type of T-cell lymphoma and its stage, the oncologist selects the most appropriate diagnostic methods for the disease.

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Differential diagnosis

Differential diagnostics is an important point in establishing an accurate diagnosis, especially in cutaneous lymphomas, which in many ways resemble dermatological pathologies (for example, eczema, psoriasis, dermatitis), and pathologies accompanied by lymphadenopathy. The latter point is very important, since the enlargement of lymph nodes can be both malignant (in lymphomas) and benign (in inflammatory processes in the body).

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Treatment T-cell lymphoma

Oncological pathologies have never been considered easy to treat, but T-cell lymphoma, despite all the danger of the situation, is not a reason to give up. The scheme and, to a greater extent, the outcome of treatment always depends on the timeliness of antitumor measures 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).
• Exposure of the tumor to ionizing radiation (electron beam therapy, which is the only method of physiotherapeutic treatment for malignant lymphomas).
• Taking corticosteroids (anti-inflammatory therapy),
• Taking drugs that activate antitumor processes in the body (biotherapy). The drugs are made directly from the patient's cellular structures.
• Bone marrow transplant. In this case, intensive chemotherapy (myeloablative therapy) is first administered, aimed at completely destroying cancer cells and suppressing the immune system to avoid transplant rejection, and then the patient is given healthy stem cells from a donor or their own, taken before the start of chemotherapy.
• Taking medications that stimulate the immune system and vitamins to boost immunity.
• Surgical treatment. Tumor removal is performed surgically only in the case of isolated lesions, mainly when the tumor process is diagnosed in the gastrointestinal tract. To avoid tumor recurrence after its removal, chemotherapy with several antitumor drugs simultaneously is indicated (polychemotherapy).

Surgical treatment of T-cell lymphoma is not always justified. Firstly, in most cases, several lesions are found, and the migration of pathological cells through the lymphatic system contributes to the fairly rapid spread of the disease to other organs (metastasis), which sometimes requires not one, but several operations. And if we consider that cancer significantly weakens the body, then not every patient can endure even one, let alone several surgical interventions.

The approach to treatment, of course, may vary depending on the localization and prevalence of the process. Thus, for the treatment of a mild form of mycosis fungoides (erythematous), corticosteroids and interferon preparations are indicated. Chemotherapy is not prescribed, radiation is not performed.

In other forms of T-cell cutaneous lymphomas, both systemic and local treatment can be prescribed. Local treatment of skin cancerous T-pathologies can be carried out with the drug in the form of a gel "Valchlor" produced in the USA. Unfortunately, this drug is still unavailable in our country.

The active substance of the drug is mechlorethamine. Drugs with this active substance (for example, "Embikhin") are used for systemic therapy of T-cell forms of skin cancer. Also, such antitumor agents as "Vinblastine", "Fludarabine", "Dacarbazine", "Chlorbutin", "Adriamycin", "Vincristine", "Cyclophosphamide" and others can be used as part of polychemotherapy.

In case of skin pathologies, antitumor antibiotics (for example, Rubomycin), corticosteroids (for example, Prednisolone, Triamcinolone) and phototherapy (usually PUVA therapy) are also used.

In biotherapy of T-cell lymphomas, both patient cell preparations and monoclonal antibodies in the form of Rituxan, MabThera, Campath, Campath, Avastin, and Bexar can be used.

Treatment of the consequences of high-dose myeloablative therapy is carried out using the drugs "Filstim", "Zarcio", "Neupomax", etc.

Medicines can be administered orally or intravenously. Most drugs are intended for drip administration. Treatment should be carried out under strict supervision of an oncologist.

Radiation therapy for T-cell lymphoma is usually carried out in a course of 21-40 days. Irradiation is local, without damaging other parts of the body. The time and dose of radiation are determined by a radiologist depending on the localization and stage of the tumor process.

At the initial stages of the pathology, radiation therapy can be prescribed as an independent method of treatment, then it is used in combination with chemotherapy.

In smoldering forms of T-lymphoma, doctors are in no hurry to prescribe conservative treatment, taking a wait-and-see approach. The patient is regularly monitored by an oncologist, and in case of exacerbation, he will be prescribed effective therapy in accordance with the type of pathology.

Medicines for T-cell lymphoma

It is worth mentioning right away that the treatment of cancer of any etiology is a serious issue that should be dealt with by specialists. What types of drugs will be effective for a specific pathology, and what treatment regimen to use, is decided by a specialist doctor. Doctors categorically do not recommend prescribing treatment for yourself.

There are quite a lot of drugs for the treatment of tumor diseases today. If we talk about their effectiveness, it is worth noting: timely initiation of therapy in most cases gives positive results. It is clear that advanced stages of cancer are beyond the power of even 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.

Let's look at just a few of the drugs that doctors use to treat T-cell lymphomas of various origins.

"Embikhin" is an alkylating cytostatic drug, the action of which is aimed at the destruction of the cellular structure of T-lymphocyte clones with gene mutations.

The drug is administered intravenously according to one of two schemes:

• The shock method is designed for a 4-day course of chemotherapy. Every day, once a day, the patient is administered the drug in a dosage determined as 0.1 mg per kilogram of weight. Sometimes the drug is prescribed in a full dosage once.
• Fractional method. The medicine is administered 3 times a week. The usual dosage is 5-6 mg. The course is from 8 to 20 administrations.

It can be administered into the pleural and abdominal cavities.

The drug is not prescribed for complicated cases of the disease, severe anemia, and some blood diseases (leukopenia and thrombocytopenia). The question of the possibility of using the drug will also arise in the case of severe kidney and liver damage, as well as cardiovascular pathologies.

Common side effects include changes in blood characteristics, symptoms of anemia, gastrointestinal disorders, and sometimes weakness and headaches. If the drug gets under the skin during injection, it can cause the formation of an infiltrate and tissue necrosis at the injection site. The severity of the main side effects during intensive therapy is much stronger than with fractional administration of the drug.

"Vinblastine" is an antineoplastic drug based on the alkaloid periwinkle. It has an antitumor effect due to the fact that it blocks cell division.

The drug can only be administered 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 1 square meter of body surface (children's dose from 3.75 to 5 mg per 1 sq.m.). The drug is prescribed once a week, sometimes once every 2 weeks.

There is another administration scheme, in which treatment is started with the minimum pediatric dose, gradually increasing it to 18.5 mg per 1 sq.m. of body. For children, the initial dose will be 2.5, and the maximum 12.5 mg per 1 sq.m.

The course of treatment with the drug depends on the white blood cell count in the blood.

The drug is not used in cases of severe suppression of bone marrow function, infectious pathologies, during pregnancy and breastfeeding. The drug cannot be used in case of hypersensitivity to its components.

Common side effects: leukopenia and granulocytopenia. Disturbances in other organs and systems are observed much less frequently.

"Rubomycin" is a drug that belongs to the category of antitumor antibacterial agents, i.e. it simultaneously fights both cancer and bacterial cells.

The drug is also administered intravenously to avoid the appearance of infiltrate and necrosis of skin tissue. The drug is prescribed for a 5-day course, during which the patient receives the drug at a dosage of 0.8 mg per 1 kg of weight. The course is repeated 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 1 kg of weight per day. Children's dose is 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 antitumor agents, in which the dosage and frequency of administration may differ.

Contraindications to the use of the drug are considered to be severe pathologies of the heart, blood vessels, liver and kidneys, suppression of bone marrow function, periods of pregnancy and lactation. In acute infectious pathologies, there is a risk of developing various complications. It is prohibited to drink alcohol.

The most common side effects are granulocytopenia and thrombocytopenia (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 bone marrow stem cells remain unaffected, which means that T-lymphocyte production does not suffer. Mature and malignant lymphocytes die.

The drug is administered into the body by infusion, and the intravenous infusion process is long and takes at least 2 hours. To avoid allergic reactions and pain, analgesics and antihistamines are taken before the IV.

The medicine is administered over 3 days according to a scheme with increasing dosage: 3, 10 and 30 mg, while the body's reaction to the drug is constantly monitored. Then the medicine is administered every other day for 1-3 months. The dosage remains maximum - 30 mg per day.

If the drug is poorly tolerated and side effects occur, the dose is increased gradually only after the reaction to the drug returns to normal.

The drug is prohibited for use in patients with an acute stage of infectious pathology of a systemic nature, including cases of HIV infection, tumors of a non-lymphocytic nature, during pregnancy and breastfeeding, in case of hypersensitivity to the components. The drug is discontinued if toxic reactions are observed or further progression of the disease is observed.

There is insufficient information about the effect of the drug on the child's body.

The most common side effects of the drug are: chills, fever, fatigue, decreased blood pressure, headaches. Many people experience gastrointestinal reactions in the form of nausea, sometimes with vomiting, and diarrhea, changes in blood composition (decreased levels of granulocytes and platelets, anemia), hyperhidrosis, allergic reactions. Sepsis, herpes simplex, and pneumonia may also develop. Quite often, patients report a feeling of shortness of breath (dyspnea).

"Neupomax" is a drug that stimulates the production of leukocytes, the active substance is filgrastim.

Administration of high doses of chemotherapy drugs before bone marrow transplantation often leads to a decrease in the production of white blood cells, which must be corrected before the procedure. The same phenomenon can be observed after conventional chemotherapy. Therefore, patients with neutropenia (insufficient production of neutrophilic white blood cells) are prescribed drugs based on filgrastim.

The drug is prescribed one day after chemotherapy at a dosage of 5 mcg per day. The drug is administered subcutaneously. The course of treatment is no more than 14 days. The therapy is continued until the optimal number of neutrophils in the blood is achieved.

In myeloablative therapy, the drug is prescribed in a dosage of 10 mcg for 4 weeks. It is administered intravenously by drip.

The drug is not used in severe congenital neutropenia (Kastmann syndrome) and hypersensitivity to the components of the drug. Caution is exercised in sickle cell anemia.

Side effects of the drug include: dyspeptic symptoms, myalgia and arthralgia, enlarged liver and spleen, infiltrate in the lungs, bronchial spasms and dyspnea. Also sometimes observed is a decrease in bone density, blood pressure surges, increased heart rate, facial edema, nosebleeds, weakness. In some cases, changes in blood composition are observed: a decrease in platelet levels and an increase in leukocytes (thrombocytopenia and leukocytosis). Protein and blood may be found in the urine (proteino- and hematuria).

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Alternative Cancer Treatments

It would seem that effective methods of fighting cancer exist (the same radiation and chemotherapy), and there are enough drugs capable of killing malignant cells, but not everyone can afford such treatment. In addition, traditional medicine methods leave behind many new problems that again have to be treated.

For example, the consequences 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 added to the existing one. For men, chemotherapy can threaten the inability to have children (infertility).

Complications after radiation therapy are also not uncommon. This may include decreased thyroid function (hypothyroidism usually develops), development of radiation pneumonitis, characterized by cicatricial formations in the lung tissue, inflammation of the intestines or bladder (colitis and cystitis), insufficient saliva production, radiation burns.

It turns out that we treat one thing - we cripple another. This moment and the high cost of therapy for T-cell lymphoma and other oncological pathologies push people to search for more and more new methods of treating the terrible disease.

There are many posts on the Internet about cancer treatment using alternative methods. Some people reject folk treatment, citing the fact that it did not save the lives of their friends, while others actively use it, achieving good results. We will not take either side, but will only provide some information about the drugs used outside the oncology hospital.

Many supporters of alternative cancer treatment (including many doctors!) agree that the cause of malignant tumors is the acidic environment of the body, which lacks oxygen for normal cell functioning. If you increase the pH level of the internal environment, cellular respiration improves and cell proliferation stops. It turns out that products that reduce the acidity of the body and improve the supply of oxygen to cells can stop the development of malignant processes.

A special role in this regard is given to a product present in virtually every kitchen – baking soda. As an alkali, it is capable of reducing the acidity of any environment, including the internal environment of the body. Soda is recommended to be used both orally (alkalizes the gastrointestinal tract, getting into the blood in some quantity) and in the form of injections, which allows the alkali to be delivered to all corners of the body through the blood. However, it is recommended to extinguish the soda with boiling water beforehand.

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 teaspoons), diluting it with hot water and washing it down with a glass of liquid (water, milk). It is necessary for the soda solution to come into direct contact with cancer cells, therefore, lotions, inhalations, injections, and douches are also used to treat various types of cancer.

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 using soda and hydrogen peroxide. In this case, not pure peroxide is used, but its solution (1 to 10 drops of 3% hydrogen peroxide are taken per 50 ml of water). The remedy is taken three times a day an hour before meals, increasing the number of drops of peroxide by 1 each day (the first day - 1 drop, the second - two, etc.). After 10 days of treatment, a 5-day break is taken.

By the way, in order to reduce the acidity of the internal environment and block the path of cancer, scientists who are proponents of alkalization of the body advise paying special attention to your diet, since our diet contains products that can either increase or decrease pH. Alkalizing products include greens, fruits (except very sweet ones), dried apricots, almonds, milk and dairy products, berries, vegetables. But meat, sausages and smoked meats, fish and seafood, eggs, pastries, grape juice, jam, preserves, on the contrary, increase the acidity of the body. By the way, lemon without sugar is considered an alkalizing product, despite its acidity, but if you eat it with sugar, its effect will be the opposite.

Of interest is such a method of fighting cancer as drinking beetroot juice, which also improves cellular respiration and is able to stop the growth and development of cancer cells. And if we also take into account the rich vitamin and mineral composition of the bright red root vegetable, then we can say with confidence that treatment with its help will help strengthen the immune, nervous and other systems of the body. And this will give the body the opportunity to independently fight various diseases, including cancer.

Taking beetroot juice goes well with traditional treatments and even reduces their negative effects. But there is also information about curing cancer with beetroot juice alone, which is much cheaper than a course of treatment at an oncology hospital.

For treatment, use freshly squeezed juice, kept in the refrigerator for at least 2 hours, made from brightly colored table varieties. In order to obtain a sufficient antitumor effect, you need to drink 600 ml of juice during the day. Drink the juice slightly warmed up half an hour before meals. You can mix it with carrot juice.

Drink beetroot juice in small sips, 100 ml per dose, daily. The course of treatment is long (1 year or more). To stabilize the condition, drink 1 glass of juice per day.

It is also useful to eat boiled beets, since with short-term heat treatment they practically do not lose their beneficial properties.

By the way, it was not for nothing that folk healers chose beetroot. Its antitumor properties are recognized by official medicine. One of the antitumor drugs has even been developed based on beetroot.

Many plants also have antitumor properties, and although herbal treatment of T-cell lymphoma and other types of cancer has not become widespread, there are positive reviews of this 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 contained in many plants:

• alkaloid-containing: Colchicum lucidum and Colchicum magnificum (tubers), celandine, barberry, rue, wormwood, yellow meadowsweet and some others,
• lactone-containing: Podophila peltata and Himalayan podophila, eucommia, helenium, Vernonia almond, gaillardia.
• Containing cardiac glycosides: white bryony, dioecious and black chokeberry, mad cucumber, colocynth, medicinal avran, etc.

It is important to understand that the above-mentioned plants contain toxic substances, which means their dosage is strictly limited.

The fruits of Japanese pagoda tree, radish seeds, clover, elderberry, and meadowsweet are also famous for their anti-inflammatory and anti-tumor effects. And as immunomodulators for T-cell lymphoma, you can use extracts of ginseng, echinacea, and eleutherococcus. Such popular plants as nettle, calendula, plantain, dandelion, and succession are not far behind.

As for homeopathy, it does not undertake to cure aggressive malignant tumors completely, but some of its remedies are quite suitable as additional and preventive ones. Thus, if after traditional treatment of malignant lymphoma exacerbations are observed. A homeopathic doctor can prescribe long-term use of homeopathic preparations Barium carbonicum (5 granules under the tongue 2 times a day) and Conium (7 granules before bedtime).

Carcinosinum and Phytolacca have proven themselves to be effective antitumor drugs, and Echinacea compositum, Mucosa compositum, Edas-308, Galium-Hel and other homeopathic medicines are used as immunostimulants.

Prevention

The issue of preventing the development of oncological pathologies with high mortality, which includes T-cell lymphoma, is quite complex. Frankly speaking, scientists still do not know a clear answer to the question: how to prevent the occurrence of cancer.

If we consider the factors that increase the likelihood of developing oncological pathologies, we can understand that not all of them can be excluded from our lives. People with hereditary predisposition and immunodeficiencies will have to make a lot of effort to avoid the fate of relatives with oncological diseases.

It is important to understand that the risk of getting cancer is lower for those people who treat inflammatory pathologies (including dermatological ones) in a timely manner, preventing their chronicity, do not work with carcinogens, live in an ecologically clean area, and are not exposed to radiation. That is, there is something to think about, because your life is at stake.

Treatment of conditions that can develop into cancer (precancerous conditions) also plays a huge role in cancer prevention. Phytotherapists have even developed a herbal mixture that prevents uncontrolled cell division. It contains: stinging nettle and plantain leaves 5 g each, meadowsweet flowers and birch catkins 10 g each, licorice (roots) in the amount of 3 g.

Mix the thoroughly crushed raw materials, take 10 g of the composition and brew 1 cup of boiling water, then keep in a water bath for about 20 minutes. After straining, it turns out that the glass is not full. You need to top it up with boiled water.

The resulting infusion should be drunk daily 3 times a day. 1 glass of medicine is enough for 1 day. It should be drunk half an hour before meals for 1 or 2 months.

Whatever the case, it is better to take all measures to prevent cancer than to then fiercely fight for your life after hearing a terrible diagnosis.

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Forecast

The prognosis for T-cell lymphoma is not very bright, especially for its aggressive types, for which there is sometimes simply no time to fight. The earlier the disease is detected, the greater the chances of defeating it. If the disease is caught at the first stage of its development, the chances of living another 5 or more years are 85-90%, depending on the type of pathology and the age of the patient.

The prognosis is worst 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 complicated lymphoblastic lymphoma can be observed only in a fifth of patients. Although if you start treating the disease at an early stage, the prognosis is quite favorable in most cases.

As for mycosis fungoides, everything depends on the form and stage of the pathology. The classic form is characterized by the best prognosis. Timely treatment in the absence of complications can give patients another 10 or more years of life. With complicated pathologies, life expectancy is reduced to 2-5 years. But with the Vidal-Brock 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 attitude. In medical practice, there have been cases of "miraculous" healing, when people who were on the brink of the grave, whom doctors could no longer help, recovered only because they believed in the possibility of defeating the deadly disease. No matter how the circumstances develop, you should never give up, because life is the greatest value for a person, and it is worth fighting for.

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