Summary about Disease
Follicular lymphoma (FL) is a type of non-Hodgkin lymphoma (NHL), a cancer that starts in white blood cells called lymphocytes. Specifically, it is a slow-growing or indolent lymphoma that arises from B lymphocytes (B cells). FL typically involves lymph nodes and bone marrow, but it can also affect other organs. It's characterized by the abnormal clumping together (follicles) of cancerous B cells. While often slow-growing, it can transform into a more aggressive type of lymphoma over time.
Symptoms
Painless swollen lymph nodes, often in the neck, armpits, or groin
Fatigue
Night sweats
Unexplained weight loss
Fever
Abdominal swelling or discomfort
Feeling full after only a small amount of food
Enlarged spleen
Causes
The exact cause of follicular lymphoma is unknown. However, it is believed to develop when genetic mutations occur in B lymphocytes. These mutations cause the cells to grow and divide uncontrollably, and to live longer than normal cells. This accumulation of abnormal B cells leads to the formation of lymphoma. Some possible risk factors include:
Older age
Family history of lymphoma
Exposure to certain chemicals
Medicine Used
Treatment for follicular lymphoma depends on the stage and grade of the lymphoma, as well as the patient's overall health. Common treatment options include:
Watchful waiting: For slow-growing, asymptomatic cases.
Chemotherapy: Such as CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or bendamustine.
Immunotherapy: With rituximab or obinutuzumab (monoclonal antibodies targeting the CD20 protein on B cells).
Targeted therapy: such as PI3K inhibitors (e.g., copanlisib, duvelisib) or BTK inhibitors (e.g., ibrutinib) in relapsed/refractory settings.
Radiation therapy: To shrink localized tumors.
Stem cell transplant: In certain aggressive or relapsed cases.
CAR T-cell therapy: For relapsed/refractory cases.
Is Communicable
No, follicular lymphoma is not contagious or communicable. It cannot be spread from person to person.
Precautions
There are no specific precautions to prevent follicular lymphoma since the cause is unknown. However, general healthy lifestyle choices may be beneficial. Individuals undergoing treatment for follicular lymphoma may need to take precautions to avoid infection due to a weakened immune system. These precautions include:
Frequent handwashing
Avoiding close contact with sick people
Getting vaccinated against preventable diseases (as recommended by your doctor)
Avoiding raw or undercooked foods
How long does an outbreak last?
Follicular lymphoma is not an "outbreak" in the traditional sense of an infectious disease. It is a chronic condition, and the disease process can last for many years. Periods of remission (where the disease is under control) and relapse (where the disease returns) are common. The duration of these periods varies significantly from person to person.
How is it diagnosed?
Physical exam: To check for swollen lymph nodes.
Lymph node biopsy: The removal of a lymph node or a portion of a lymph node for examination under a microscope. This is the primary method for diagnosing follicular lymphoma.
Bone marrow biopsy: To determine if the lymphoma has spread to the bone marrow.
Imaging tests: Such as CT scans, MRI scans, and PET scans, to determine the extent of the lymphoma in the body.
Blood tests: To evaluate blood cell counts, liver and kidney function, and other markers.
Flow cytometry: A test to identify the specific types of cells present in the lymph node or bone marrow sample.
Timeline of Symptoms
The timeline of symptoms can vary greatly. Some people may have follicular lymphoma for years without experiencing any symptoms (asymptomatic). In others, symptoms may develop gradually over months or years.
Early stages: Painless swollen lymph nodes may be the only noticeable symptom.
Later stages: As the lymphoma progresses, more systemic symptoms such as fatigue, night sweats, weight loss, and fever may develop.
Relapse: After treatment, the lymphoma may return, and symptoms may reappear.
Important Considerations
Follicular lymphoma is often slow-growing, but it can transform into a more aggressive lymphoma.
Treatment options are evolving, and new therapies are becoming available.
Clinical trials may be an option for some patients.
Regular follow-up with an oncologist is essential to monitor the disease and manage any complications.
Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and stress management, can improve overall well-being.
Psychological and emotional support can be beneficial for patients and their families.