National Science Popularization Day 2021 | Boost your confidence! More than 80% of lymphomas can be effectively controlled

September 15

World Lymphoma Awareness Day

From CCTV's famous announcer Luo Jing and young actor Li Yu to Hong Kong's well-known industrialist Henry Fok and Innovation Works CEO Kai-Fu Lee, they have all been diagnosed with lymphoma, but they had different outcomes because of the different types of lymphoma they suffered.

Recently, the news that a team of hematologists at Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine successfully treated Aunt Chen, who suffered from diffuse large B-cell lymphoma, with Akiram injection became a hot topic, greatly increasing the confidence of many patients with similar diseases in fighting cancer.

What is lymphoma? Can it be cured?

Today is World Lymphoma Awareness Day. Let us learn about this disease together.

What is lymphoma?

Lymphocytes are widely distributed in lymph nodes and lymphatic tissues throughout the body and are the "health guardians" of the human body. Lymphocytes undergo malignant changes and form malignant tumors called lymphomas. Since lymphatic tissues are distributed throughout the body and are closely related to the blood system and immune system, lymphomas can occur in various parts of the body, such as the heart, liver, spleen, lungs, etc.

The most typical manifestation of lymphoma is superficial lymphadenopathy, especially the enlargement of cervical lymphadenopathy. In addition, about half of lymphoma patients have fever. Most patients have weight loss, losing more than 10% of their original body weight within 6 months. Some patients also have systemic symptoms such as general weakness, weight loss, loss of appetite, night sweats, rash, itching, anemia, etc.

There is no clear cause of lymphoma yet, but some infectious factors, abnormal immune function, environmental pollution, etc. are likely to be the main reasons for the significant increase in the incidence of lymphoma in recent years. In addition, frequent hair dyeing, excessive stress and fatigue are also related to its occurrence.

Does swollen lymph nodes mean I have lymphoma?

Lymphoma is a disease that is good at "disguising itself". The first symptoms are not obvious, mostly painless and superficial lymph node swelling, such as swelling of the neck, groin and armpit lymph nodes. Since these parts are easy to touch, when similar symptoms appear, you should "touch yourself" in time for the first screening, which will help early diagnosis and treatment.

Although some inflammations can also cause swollen lymph nodes, in general, lymph nodes caused by inflammation are relatively soft and painful when pressed, while lymph nodes caused by lymphoma are painless, smooth, and tough. If you experience such painless and itchy lymph node enlargement or unexplained fever, night sweats, weight loss, itching, etc., do not relax your vigilance and go to the hospital as soon as possible.

The first treatment is crucial

There are nearly 70 known types of lymphoma, and the treatment and prognosis of different types vary significantly.

Clinically, lymphoma is mainly divided into Hodgkin lymphoma (about 10%) and non-Hodgkin lymphoma (about 90%). Among them, diffuse large B-cell lymphoma accounts for the largest proportion of non-Hodgkin lymphoma, nearly half.

When it comes to cure rates, Hodgkin's lymphoma is a relatively effective malignant tumor. If the lymphoma patient is in stage I-II, the 10-year survival rate can reach about 90% after standardized treatment. However, the overall cure rate of non-Hodgkin's lymphoma is not so ideal. For example, the 6-year survival rate of patients with diffuse lymphocyte differentiation is 61%; the 6-year survival rate of patients with poor diffuse lymphocyte differentiation is 42%; and the 4-year survival rate of lymphoblastoid type is only 30%.

For lymphoma, the success of the first treatment determines whether the disease can be controlled. In other words, the first treatment plan is crucial. Therefore, it is recommended that lymphoma patients immediately cooperate with specialists for standardized and reasonable treatment after being diagnosed by pathology, so as to achieve good treatment effects, improve survival rates, avoid delays in the disease, and even induce drug resistance.

Currently, chemotherapy is the main treatment for lymphoma. Some patients can also receive combined immune targeted therapy or radiotherapy.

In fact, due to the continuous improvement of lymphoma classification and treatment plans, the treatment effect of lymphoma has been significantly improved. At present, more than 80% of lymphoma can be effectively controlled. Therefore, patients should dispel excessive fear of malignant lymphoma and actively and reasonably carry out treatment.

Latest progress in therapeutic drugs

Recently, good news about the progress of lymphoma treatment drugs has been frequently reported, which has also brought great hope to patients.

In June this year, Otuzumab was officially approved by the National Medical Products Administration for use in combination with chemotherapy for the treatment of adult patients with stage II with large tumors, stage III or stage IV follicular lymphoma who are undergoing initial treatment. On August 26, Professor Huang Huiqiang of the Cancer Prevention and Treatment Center and Lymphoma Center of Sun Yat-sen University wrote the first prescription for Otuzumab, which also means that this newly approved drug has officially entered the clinic to benefit patients.

On June 22, the official website of the National Medical Products Administration announced that the country's first CAR-T cell therapy product, Akiramu injection, has been officially approved; on August 26, the country's first patient with diffuse large B-cell lymphoma who received Akiramu injection treatment was discharged from the Department of Hematology of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.

On September 3, the official website of the National Medical Products Administration showed that the CAR-T therapy product Ruiqiolunsai injection was approved for marketing. It is used to treat relapsed or refractory large B-cell lymphoma (LBCL) in adult patients after two or more lines of systemic treatment. It is believed that this new drug can also enter the clinic as soon as possible to benefit more patients.

Since some patients may relapse, regular follow-up examinations are required. Usually, the risk of relapse is relatively high in the first two years, and follow-up examinations are required every 3 months; after two years, follow-up examinations are required every 6 months; after 5 years, follow-up examinations can be performed once a year.

Paying attention to a balanced diet, keeping a good mood, actively exercising, and being optimistic will help prevent diseases.

Author: Li Haiyan, Deputy Director and Pharmacist of the Pharmacy Department of Xi'an Fourth Hospital

Review expert: Jia Xiaoni, deputy director and pharmacist of the pharmacy department of Xi'an Jingwei Center

Yang Jun, deputy director and pharmacist of the Pharmacy Department of the Cancer Hospital of the Chinese Academy of Medical Sciences