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The Silent Killer of the Immune System: Do You Know What Indolent Lymphoma Is?
Among many cancers, indolent lymphoma is known for its slow growth characteristics, making it difficult for many patients to detect it during the initial diagnosis. This group of non-Hodgkin lymphomas (NHL) includes common subtypes such as follicular lymphoma, cutaneous T-cell lymphoma, and marginal zone lymphoma. The disease mainly affects the elderly, and although it progresses slowly, patients may be at risk of worsening of the disease if it is not treated promptly.
Indolent lymphoma often presents as painless enlarged lymph nodes and is closely related to factors such as age, infection and family history.
Clues: Signs and symptoms
When patients develop swollen lymph nodes, they are usually in the neck, armpits, or groin and are often not accompanied by pain. In some people, swollen lymph nodes may be hidden in the chest or abdomen until they become very large and cause symptoms such as coughing or abdominal pain. Other possible symptoms include unexplained fever and unexpected weight loss.
Risk Factors
Age
The risk of developing indolent lymphoma increases with age. Although the disease can occur at any age, it mainly affects older people, with a low incidence in people under 40 years old and extremely rare in children.
Infection
People who receive an HIV diagnosis have a slightly higher risk of developing indolent lymphomas compared with the general population. For patients who have been diagnosed with AIDS-defining disease, the risk rises to 14 times.
Other factors
A history of non-Hodgkin lymphoma or a hematological malignancy in the immediate family or infection with hepatitis C is associated with an increased risk of indolent lymphoma. Additionally, a higher body mass index (BMI), working as a spray painter, and a sedentary lifestyle were associated with an increased risk of follicular lymphoma.
Through these potential risk factors, the medical community is continuing to elucidate the causes of indolent lymphoma.
Diagnostic Process
Classification method
Indolent lymphomas usually originate from B cells and are classified based on pathological and cellular characteristics. The main subtypes include follicular lymphoma, marginal zone lymphoma, and lymphoplasmacytic lymphoma.
Follicular lymphomaFollicular lymphoma is the most common indolent lymphoma. Approximately 85% of cases show chromosomal translocation t(14;18), which is characterized by lymph node and bone marrow involvement.
Cutaneous T-cell lymphoma
This lymphoma originates from T cells and, in its most common form, is a fungal disease whose diagnosis is often delayed due to its variable clinical presentation.
Marginal zone lymphoma
This is a heterogeneous B-cell lymphoma arising from the marginal zone of lymphoid tissue and accounts for 5-10% of all NHLs.
Treatment methods
Indolent lymphomas usually grow slowly, so patients may not need immediate treatment in the early stages and doctors may take a watchful waiting approach. When the disease worsens, treatment is given according to different subtypes and stages.
Treatment plans for different stages
For people with early-stage disease, radiation therapy is usually effective. But for patients in the advanced stage, treatments such as monoclonal antibody therapy, chemotherapy and other innovative therapies are the main options.
Treatment alone does not necessarily guarantee a cure, and many patients still face the challenge of not being able to be completely cured.
Looking to the future
Although the overall survival rate of indolent lymphoma is relatively high and many patients can live for more than ten years, due to the different prognoses of different subtypes, whether it can be cured in the future still needs further exploration. Especially for young patients, early detection and intervention will be particularly critical.
Against this backdrop, can we better identify and understand this potential “silent killer”?
