2023-06-20 01:05:14
Know “diffuse large B-cell lymphoma” and beware of 6 warning signs of the body
Ms. Zhang, in her 60s, was intubated and admitted to the intensive care unit due to pneumonia and respiratory failure. After the examination, she found a huge tumor in the abdominal cavity, which caused pressure on the surrounding organs.diffuse large B cell lymphoma(DLBCL, Diffuse Large B Cell Lymphoma for short), Dr. Wang Haoyuan, Department of Hematology, Taipei Veterans General Hospital recalled that although the patient’s condition was not very good at that time, after detailed discussion with his family, he decided to start active treatment because of diffuse large B cell lymphoma. Cellular lymphoma (DLBCL) has the potential to be curable.
Dr. Wang Haoyuan said, “We adjusted the dose of the drug very carefully, so that the tumor gradually shrank, and the pneumonia also improved smoothly. The patient was transferred to the general ward to continue to receive treatment, and the effect was quite good. It has been nearly five years now. Diffuse large B-cell lymphoma (DLBCL) have not relapsed.”
“The treatment goal of Diffuse Large B-cell Lymphoma (DLBCL) is to cure!” Dr. Wang Haoyuan said, “Diffuse Large B-Cell Lymphoma (DLBCL) not only has a cure rate of 60% in the first-line treatment, but the response to treatment is not good. In addition to the existing salvage chemotherapy and stem cell transplantation, immune and cell therapy is also available for patients with relapse or relapse. Through genetic engineering, immune cells can accurately and continuously destroy cancer cells, improving the cure rate of refractory or relapsed lymphoma. “
Lymphoma from immune cells
Lymphoma is lymphoma, which is derived from the transformation of “lymphatic white blood cells that should have defended the body” into cancer cells.
Lymphoma can be divided into two categories, “Hodgkin’s lymphoma” and “Non-Hodgkin’s lymphoma”. Dr. Wang Haoyuan pointed out that if it is a pathological section of “Hodgkin’s lymphoma”, under the microscope, There are usually only a few cancer cells, and it is very hard to find them. On the contrary, if it is a pathological section of “non-Hodgkin’s lymphoma”, most of the visual field is cancer cells.
“Non-Hodgkin’s lymphoma” can be further divided into indolent and aggressive lymphomas according to the growth rate of the tumor, while the cancer cells of diffuse large B-cell lymphoma grow rapidly , the course of the disease develops rapidly and aggressively. If not treated in time, the patient may be life-threatening within a few weeks to a few months, so early detection and treatment of the disease are very important.
Six warning signs, beware of non-Hodgkin’s lymphoma
Symptoms of non-Hodgkin’s lymphoma generally talk about “Big B Symptoms(B Symptoms), including weight loss, fever, night sweats, etc. Physician Wang Haoyuan said that night sweats mean that the bed sheets will still get wet even if the weather is cold after the patient wakes up from sleep. Fever is a fever that occurs almost more than half of the time in a month, not just occasionally. Weight loss is losing 10% or more of your body weight in six months.
The most commonly noticed symptoms of non-Hodgkin’s lymphoma areswollen lymph nodesDr. Wang Haoyuan said that our body has many lymph nodes, and lymph nodes are like military camps. When there is no war, the military camp may only have a small number of soldiers stationed; when there is a war, the military camp will increase the number of immune cell soldiers to deal with the nearby war; , the number of soldiers in the barracks will decrease under normal circumstances. But in the case of non-Hodgkin’s lymphoma, the number of soldiers in the military camp continues to increase and the mechanism of natural apoptosis is lost, forming a force like a warlord that endangers the health of patients.
“Non-Hodgkin’s lymphoma not only emerges from the lymph nodes, but can also arise anywhere in the body, including the skin, testicles, breasts, kidneys, and even the brain.” Dr. Wang Haoyuan emphasized, “Lymphoma If it appears in the abdominal cavity, it may make the patient’s appetite worse; if it grows in the head, the symptoms may be like dementia and stroke; if it compresses the airway, the patient will cough, wheeze or feel oppressed.”
Dr. Wang Haoyuan reminded that the symptoms of lymphoma are quite diverse, if foundBurning, swelling, itching, sweating, coughing, thinningWaiting for the warning sign, you must go to the hematology department as soon as possible.
What is diffuse large B-cell lymphoma (DLBCL)?
Among non-Hodgkin’s lymphomas, diffuse large B-cell lymphoma (DLBCL) is the most common type in my country, because the course of the disease develops rapidly and can easily invade the organs of the whole body, and its malignancy is quite high.
According to Dr. Wang Haoyuan, about 2,500 new cases of lymphoma are diagnosed in Taiwan every year, about 2,300 of which are non-Hodgkin’s lymphoma, and about 1,000 of which are diffuse large B-cell lymphoma (DLBCL).
Aggressive treatment to eradicate diffuse large B-cell lymphoma (DLBCL)
The first-line treatment of diffuse large B-cell lymphoma is mainly through drugs, including steroids, chemotherapy, targeted therapy, etc. Dr. Wang Haoyuan said that the first-line treatment is called R-CHOP, and each letter represents a drug, including a Targeted drugs, with three chemotherapy treatments, plus steroids. Steroids are somewhat stigmatized in Taiwan, but steroids are very important drugs for the treatment of lymphoma. They can directly kill lymphoma cells and have an antiemetic effect, which can relieve nausea and vomiting caused by chemotherapy.
When diffuse large B-cell lymphoma (DLBCL) relapses, high-dose chemotherapy combined with hematopoietic stem cell transplantation can be used for treatment. Dr. Wang Haoyuan said that the purpose of high-dose chemotherapy before transplantation is to eliminate the remaining cancer cells in the patient as much as possible. Then autologous (patient’s own) or allogeneic (donor’s) hematopoietic stem cells are reinfused into the patient’s body. Among them, allogeneic hematopoietic stem cell transplantation can establish a new immune system in the patient and continue to shoulder the task of destroying the remaining cancer cells. However, high-dose chemotherapy has strong side effects and puts a great test on the patient’s physical function, while allogeneic transplantation needs to be careful to deal with the problem of internal rejection, which affects the quality of life of the patient.
Dr. Wang Haoyuan analyzed the treatment effect of diffuse large B-cell lymphoma (DLBCL) in the past. For every 100 patients, 60 patients can be cured with first-line drug therapy (R-CHOP), and the remaining 40 patients need to face The recurrence of the disease, the faster the recurrence, the poorer the prognosis of patients. Generally speaking, only 5 to 10 of these 40 patients can be saved. This is the current treatment dilemma for diffuse large B-cell lymphoma.
What is cellular immunotherapy?
Fortunately today there arecellular immunotherapyIt can be used as a new treatment weapon. Dr. Wang Haoyuan explained that in addition to fighting against bacteria and viruses invading the body, immune cells can also detect and eliminate cancer cells in the body. Therefore, cellular immunotherapy uses this feature to use immune cells as healing weapon.
There are currently two ways. The first is to replicate immune cells in large numbers and inject them into patients. The second is the current mainstream method, which is to isolate immune cells (mainly T cells) from the peripheral blood of patients, and then use genetic engineering to modify immune cells, so that immune cells can self-activate and accurately find cancer cells. After the cells have been cultured in large quantities in vitro, they are reinfused back into the patient’s body. A one-time injection is expected to help some patients cure refractory or relapsed diffuse large B-cell lymphoma (DLBCL).
Intimate reminder
The symptoms of non-Hodgkin’s lymphoma are quite diverse. If there are warning signs such as fever, swelling, itching, sweating, coughing, and thinness, you must see a hematologist as soon as possible.
Dr. Wang Haoyuan reminds that the goal of treatment for diffuse large B-cell lymphoma (DLBCL) is to cure, please cooperate closely with the doctor and work together to achieve a better prognosis!
This health education information is provided by Novartis Taiwan
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