AIDS-Related Lymphoma

AIDS-Related Lymphoma

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Acquired immune deficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV), which attacks and weakens the body's immune system. In AIDS-related lymphoma, cancer cells form in the lymphatic system of patients who have AIDS. The lymphatic system helps the body get rid of toxins, waste, and other unwanted materials. It is estimated that 25%-40% of patients suffering from HIV infection will develop a malignancy at any stage of life. Up to 85% of AIDS-related lymphomas are highly aggressive in nature.

What are the symptoms of AIDS related Lymphoma?

AIDS related lymphoma may show signs and symptoms like:

  • Unintended weight loss
  • Fever
  • Soaking night sweats
  • Swollen and painless lymph nodes in the chest, neck, underarm, or groin.
  • Feeling of fullness below the ribs.

How is AIDS related lymphoma diagnosed?

Patient suffering from AIDS related lymphoma when visiting the doctor with symptoms, he will do a physical check-up to identify the problem.

  • Physical examination: Your doctor will do a physical check-up and look for signs of the disease, such as lumps or anything unusual. A history of the patient’s health, including symptoms like weight loss, fever, etc., will also be taken.

Based on the observations from the physical examination, he will suggest some tests that will help confirm the diagnosis.

  • Complete blood count (CBC): A blood sample is collected and then sent to the laboratory to look for any abnormal values. The CBC is used in diagnosing and monitoring many different conditions.
  • Blood chemistry studies: The doctor may recommend a blood test to measure the amounts of certain substances released by the organs and tissues into the blood. Any abnormality can be a hint of the disease.
  • Lactic dehydrogenase (LDH) test: A procedure in which a blood sample is checked to measure the amount of lactic dehydrogenase. An increased LDH amount in the blood may signify tissue damage, lymphoma, or any other disease.
  • Hepatitis B and hepatitis C test: This test measures the amounts of antigens and/or antibodies of the hepatitis B virus and the amounts of hepatitis C virus-specific antibodies. These antigens or antibodies are called markers. Different markers or their combination markers are used to determine whether a patient has a hepatitis B or C infection, has had prior infection or vaccination, or is prone to infection.
  • HIV test: This test is done to measure the level of HIV antibodies in a sample of blood. A high level of HIV antibodies may indicate the body has been infected with HIV.

What are the next steps after confirmation of AIDS related Lymphoma?

After confirmation of AIDS related lymphoma, your doctor may ask you to go for additional tests to determine the spread of the tumor to the lymph nodes or other areas of your body. These tests also help in determining the grade of AIDS related lymphoma. These tests may include:

  • CT scan: This test uses a special dye medium that helps with a clear image of the body parts from different angles. It can help in seeing detailed images of soft tissue and blood vessels. CT scan is used to measure the tumor size and helps look for the spread of the tumor to different body organs.
  • Magnetic resonance imaging (MRI): An MRI uses magnetic fields to produce detailed body images. It helps in measuring the size of the tumor and also to look for the spread of cancer.
  • Bone marrow aspiration and biopsy: During the procedure, bone marrow is removed from the patient’s hip bone, and the sample is sent to the laboratory for examination.
  • Lymph node biopsy: The removal of complete or part of a lymph node is known as lymph node biopsy. The sample is sent to a laboratory for review under a microscope to look for cancer cells.
  • Positron emission tomography (PET) or PET-CT scan: A PET scan uses a small amount of radioactive sugar substance, which is injected into the patient's body. This sugar substance is then used by cells, and a scanner then detects this substance to make images of the body's internal organs.

What are the stages of AIDS related Lymphoma?

  • Stage I: Divided into two stages:
    • Stage I: Cancer cells are found in one of the following places in the lymphatic system:
    • 1 or more lymph nodes in a group of lymph nodes.
    • Spleen.
    • Thymus.
    • Waldeyer's ring.
    • Stage IE: Cancer cells are found in one area outside the lymph system.
  • Stage II: Divided into stages II and IIE.
    • Stage II: Cancer cells are found in two or more groups of the lymph nodes that are either above or below the diaphragm.
    • Stage IIE: Cancer cells have spread from a group of lymph nodes to a nearby area that is outside the lymphatic system. Tumor may have spread to other lymph node groups on the same side of the diaphragm.
  • Stage III: Cancer cells are found in lymph nodes group both above and below the diaphragm, or in a group of lymph nodes present above the diaphragm and in the spleen.
  • Stage IV: Cancer at this stage can invade in either way:
    • Cancer has spread throughout 1 or more organs outside the lymph system.
    • Cancer cells are found in two or more groups of lymph nodes that are either below or above the diaphragm and in one organ that is outside the lymph system and not near the affected lymph nodes.
    • Cancer cells are found in lymph nodes group below or above the diaphragm and in any organ that is outside the lymphatic system.
    • Cancer cells are found in the liver, bone marrow, at multiple places in the lung, or cerebrospinal fluid (CSF). Cancer has not directly spread into the liver, bone marrow, lung, or CSF from nearby lymph nodes.

How is AIDS related Lymphoma treated?

Treatment of AIDS related Lymphoma depends on many factors like the stage of the disease, the patient's age, and his overall health. A combination of various treatments such as radiation therapy, target therapy, and chemotherapy are planned for patients which are best suited for them.

  • Radiation therapy: Radiation therapy utilizes high-energy x-rays or other types of radiation to kill cancer cells. Radiation therapy can be used in a targeted area or whole body; the doctor carefully directs the energy to the affected area that focuses on killing the cancer cells.
  • Chemotherapy: Chemotherapy uses drugs that stop the cancer cells from multiplying, either by killing the cancer cells or by inhibiting them from multiplying. These drugs are administered through the vein or can be given in the form of pills. Intrathecal chemotherapy may be used in cases where patients are more likely to have lymphoma in the central nervous system (CNS).
  • Targeted therapy: This treatment uses drugs and other substances that identify and attack the cancer cells. As this treatment focuses on cancer cells, it is less harmful in comparison to radiation and chemotherapy.

How to keep a check on reoccurrence?

To keep a check on AIDS related Lymphoma, it is advisable to be vigilant with the follow-up protocol. In case of any problem you experience, inform your doctor immediately. The doctor will do a physical examination and recommend you to go for tests to learn as much as possible about the recurrence. After this testing is done, your doctor may plan the best treatment option available that might include previous treatment as well.

Tips for prevention

  • Always use a condom: Prefer using water-based or silicone-based lubricants to help avoid condoms from breaking or slipping during sex.
  • Choose sexual activities with less to no risk: Choosing sex that is less risky than anal or vaginal sex will be helpful. The risk through oral sex is minimal to no, in comparison anal or vaginal sex, as you can’t get HIV from sexual activities that don’t involve contact with body fluids (vaginal fluid, semen, or blood).
  • Avoid using shared needles, syringes, or other drug-injection equipment: Always use new and clean syringes and injection equipment every time you inject.
  • Protect others if you have HIV: Get in care and take medicine to treat HIV, and always use a condom.
  • Prevent mother-to-child transfer: Early diagnosis and treatment of HIV tend to prevent transmission to the baby. If your partner or you are involved in behaviors that put you at risk of HIV, get tested again in your 3rd trimester of pregnancy. Encourage your partner also to get tested for HIV.
  • Post-exposure prophylaxis (PEP): There is a medicine you can take to prevent getting HIV after any recent exposure. Inform your doctor right away about it and he may prescribe post-exposure prophylaxis (PEP). It must be started within 72 hours after a possible exposure. The sooner you start PEP, the better, as every hour counts. In case of a prescription of PEP, you’ll need to take it daily for 28 days.
  • Avoid smoking: Smoking is a critical risk factor for cancer, and quitting smoking will help in lowering the risk.
  • Manage weight: Being obese or overweight increases the risk of cancer. Indulge in some form of physical activity like exercising, yoga, etc., to keep your body fit.
  • Diet: People eating a diet high in fruits, vegetables, and whole grains and low in sugar drinks, processed food, and red, processed meats probably have a lower risk of cancer risk.

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