Lymphoblastic Lymphoma

A lymphoma cancer cell.
A lymphoma cancer cell. STEVE GSCHMEISSNER/SCIENCE PHOTO LIBRARY/Getty Images

Lymphoblastic lymphoma is an uncommon form of fast-growing, aggressive non-Hodgkin lymphoma (NHL), most often seen in teenagers and young adults. Another name for it is precursor lymphoblastic lymphoma. It usually is a tumor of the T cells but sometimes the cells ar B cells, and those terms will be used in naming.

What are Lymphoblasts?

A blast cell is an immature cell in the bone marrow that gives rise to mature lines of blood cells, In the case of lymphoblastic lymphoma, the disordered cell is is a lymphoblast that would normally produce a healthy line of immune system cells, the lymphocytes.

The lymphoblasts would normally live in the bone marrow, producing lymphocytes that circulate in the blood and lymphatic system, including the lymph nodes.

What Produces Lymphoblastic Lymphoma?

Lymphoblastic lymphoma is a cancer of immature lymphoblasts. It arises more commonly from T-lymphoblasts than B-lymphoblasts. It is a very aggressive lymphoma, also called high grade lymphoma. That means that the lymphoma grows quickly, and can spread fast to different parts of the body. In many ways it is similar to a leukemia. In this case, it shades into the diagnosis of acute lymphoblastic leukemia if there is more than 25% lymphoblasts in the bone marrow.

Get familiar with the names given to the different types of NHL in the article on NHL types.

Who Gets Lymphoblastic Lymphoma?:

Lymphoblastic lymphoma mostly affects young people in their late teens or early twenties. It is more common in men than in women.

It accounts for about 20% of NHL in children.

How does the disease affect the body?

This lymphoma is very fast growing. Most patients develop severe symptoms within a short span of time. Lymph nodes in the mediastinum (the central part of the chest between the lungs) are the most commonly affected. This results in a mass in the chest that leads to breathing problems and cough.

Water may also accumulate within the lungs. The bone marrow is commonly involved. The brain and spinal cord may also be affected in a number of cases.

Diagnosis and Tests for Lymphoblastic Lymphoma

The diagnosis of lymphoma is generally done with a lymph node biopsy if enlarged nodes can be easily accessed, or a needle aspiration (FNAC) under guidance of CT-scans or ultrasound scans. The disease is confirmed as a lymphoma, and the type of lymphoma is determined by looking at its cells under the microscope and special tests. Newly diagnosed patients have to undergo a series of tests to determine how far the disease affects the body. See the section on tests for the newly diagnosed.

Prognosis of Lymphoblastic Lymphoma

The prognosis of lymphoblastic lymphoma is similar in many respects to leukemias. It depends on a number of factors including the stage of disease. The factors are described in the section on prognostic factors of Non-Hodgkin Lymphoma (NHL).

Treatment of Lymphoblastic Lymphoma

Treatment is on the lines of leukemias rather than other lymphomas.

Chemotherapy is given in three phases - ‘induction’,‘consolidation’, and ‘maintenance’. Induction chemotherapy involves administration of a number of drugs through infusion and tablets over a few weeks in hospital. Following this a few drugs are administered in infusion periodically over a few months to remove any remaining cancer cells. This is called consolidation. Maintenance involves the use of drugs usually in oral form over a few years. A number of patients with lymphoblastic lymphoma achieve cure with intensive chemotherapy. In adults, intensive combination chemotherapy is given and a bone marrow transplant may be performed.

Sources:

Types of non-Hodgkin lymphoma in children, American Cancer Society, revised 01/27/2016.

Childhood Non-Hodgkin Lymphoma Treatment–for health professionals (PDQ®), National Cancer Institute, January 26, 2016.

Adult Non-Hodgkin Lymphoma Treatment–for health professionals (PDQ®). National Cancer Insitute, January 15, 2016.

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