LYMPHOMAS

AND LEUKEMIAS
Professor Mary Grace L. Araullo RN MSCPD
 DIFFERENCE BETWEEN LEUKEMIA
AND LYMPHOMAS

• Cancer can affect any part of the body, including the blood. Leukemia and
lymphoma are both forms of blood cancer.
• Both cancers typically affect the white blood cells.
• The main difference is that leukemia affects the blood and bone marrow,
while lymphomas tend to affect the lymph nodes.
• Though there are some similarities between the two types of cancer,
their causes and origins, symptoms, treatment, and survival rate are
different.
 LEUKEMIA

• Leukemia occurs when the bone

marrow produces too many abnormal
white blood cells. It is typically a slow-
growing cancer, though there are cases
where it progresses faster.
• If a person has leukemia, their abnormal
white blood cells do not die off in a
normal cycle. Instead, the white blood
cells multiply rapidly, eventually leaving
less room for red blood cells required to
carry oxygen through the body.
 ACUTE LEUKEMIA
• Acute leukemia is characterized by a rapid
increase in the number of immature blood
cells.
• The crowding that results from such cells
makes the bone marrow unable to produce
healthy blood cells.
• Immediate treatment required because of
the rapid progression and accumulation of
the malignant cells.
• Most common form of leukemia in children.
CHRONIC LEUKEMIA
• It is characterized by the excessive buildup
of relatively mature, but still abnormal,
white blood cells.
• Typically taking months or years to progress,
the cells are produced at a much higher rate
than normal, resulting in many abnormal
white blood cells.
• Chronic leukemia are monitored for
sometimes before treatment to ensure
maximum effectiveness of therapy.
• Mostly occurs in older people but can occur
in any age group.
 FOUR MAIN TYPES OF
LEUKEMIA,
CLASSIFIED ACCORDING TO
THEIR RATE OF GROWTH
AND
WHERE THE CANCER
ORIGINATED IN THE BODY.
 ACUTE LYMPHOBLASTIC LEUKEMIA, OR
ACUTE LYMPHOCYTIC LEUKEMIA (ALL),

•Leukemia happens when the body produces too many

immature white blood cells, or blast cells. In the case of ALL, it
produces too many lymphoblasts or lymphocytes. These
become leukemia cells.
•Signs and symptoms may include excessive sweating, fever,
fatigue, dizziness, easy bruising or frequent bleeding, such as
nosebleeds, difficulty breathing, painful joints, bones, or both,
panting, frequent infections, swollen lymph nodes and pale
skin.
•As ALL progresses, it can affect other organs.
If it reaches the liver and spleen, a person may experience
abdominal swelling and discomfort.
If ALL starts to affect the brain and spinal cord, the person may
have headaches, dizziness, weakness, and other symptoms.
 CHRONIC LYMPHOCYTIC
LEUKEMIA (CLL)
• Chronic lymphocytic leukemia (CLL) is a type of cancer of
the blood and bone marrow — the spongy tissue inside
bones where blood cells are made.
• The term "chronic" in chronic lymphocytic leukemia
comes from the fact that it typically progresses more
slowly than other types of leukemia.
• The term "lymphocytic" in chronic lymphocytic leukemia
comes from the cells affected by the disease — a group of
white blood cells called lymphocytes, which help your
body fight infection.
• Chronic lymphocytic leukemia most commonly affects
older adults. There are treatments to help control the
disease.
ACUTE MYELOID LEUKEMIA (AML)
• AML involves the body producing too many
nonfunctioning, immature white blood cells. These are
called blasts. They crowd out the useful cells, leading to
a range of symptoms and complications.
• The general symptoms of AML can be like those of
the flu.
• As AML spreads to other organs, a wide range of
symptoms can develop. If the blast cells enter the CNS,
for example, the person may experience headache,
blurred vision, dizziness, seizures, and vomiting.
• AML is a fast-growing cancer. Anyone who notices
unusual symptoms should see a doctor without delay.
The sooner a person starts treatment, the better the
likelihood that it will be effective.
 CHRONIC MYELOID LEUKEMIA (CML)

• Chronic myeloid leukemia (CML) is also known as

chronic myelogenous leukemia. It's a type of cancer that starts in
certain blood-forming cells of the bone marrow.
• In CML, a genetic change takes place in an early (immature) version
of myeloid cells -- the cells that make red blood cells, platelets,
and most types of white blood cells (except lymphocytes).
• This change forms an abnormal gene called BCR-ABL, which turns
the cell into a CML cell. The leukemia cells grow and divide,
building up in the bone marrow and spilling over into the blood. In
time, the cells can also settle in other parts of the body, including
the spleen.
• CML is a fairly slow growing leukemia, but it can change into a fast-
growing acute leukemia that's hard to treat.
• CML occurs mostly in adults, but very rarely it occurs in children,
too. In general, their treatment is the same as for adults.
 LEUKEMIA CAUSES AND RISK FACTORS

• No one knows exactly what causes leukemia. People who have it have
certain unusual chromosomes, but the chromosomes don’t cause leukemia.
• You can’t prevent leukemia, but certain things may trigger it. You might have
a higher risk if you:
Smoke
Are exposed to a lot of radiation or certain chemicals
Had radiation therapy or chemotherapy to treat cancer
Have a family history of leukemia
Have a genetic disorder like Down Syndrome
 LEUKEMIA DIAGNOSIS
Your doctor will need to check for signs of leukemia in your
blood or bone marrow. They might do tests including:
• Blood tests. A complete blood count (CBC) looks at the
number and maturity of different types of blood cells. A
blood smear looks for unusual or immature cells.
• Bone Marrow Biopsy. This test involves marrow taken
from your pelvic bone with a long needle. It can tell your
doctor what kind of leukemia you have and how severe it
is.
• Spinal tap. This involves fluid from your spinal cord. It
can tell your doctor whether the leukemia has spread.
• Imaging Tests. Things like CT, MRI, and PET scans can
spot signs of leukemia.
 LEUKEMIA TREATMENTS

•Chemotherapy uses drugs to kill cancer cells in your blood and bone marrow. You can get the medicine: (1)
Through a shot into a vein or muscle, (2) As a pill and (3) Into the fluid around your spinal cord.
•Radiation uses high-energy X-rays to kill leukemia cells or keep them from growing. You can get it all over or in
only one part of your body where there are a lot of cancer cells.
•Biologic therapy, also called immunotherapy, helps your immune system find and attack cancer cells. Drugs like
interleukins and interferon can help boost your body's natural defenses against leukemia.
•Targeted therapy uses drugs to block specific genes or proteins that cancer cells need to grow. This treatment can
stop the signals that leukemia cells use to grow and divide, cut off their blood supply, or kill them directly.
•A stem cell transplant replaces the leukemia cells in your bone marrow with new ones that make blood. Your
doctor can get the new stem cells from your own body or from a donor. First, you'll have high doses of
chemotherapy to destroy the cancer cells in your bone marrow. Then, you'll get the new stem cells through an
infusion into one of your veins. They will grow into new, healthy blood cells.
•Surgery. Your doctor can remove your spleen if it’s filled with cancer cells and is pressing on nearby organs. This
procedure is called a Splenectomy.
 LYMPHOMA
• The lymphomas are neoplasms of cells of
lymphoid origin. These tumors usually start
in lymph nodes but can involve lymphoid
tissue in the spleen, GI tract (e.g., the wall
of the stomach), liver, or bone marrow.
• Lymphoma is a group of blood cell tumors
that develop from lymphocytes (a type of
white blood cell). 
• Lymphomas can be broadly classified into
two categories: Hodgkin lymphoma and
non-Hodgkin lymphoma (NHL).
SYMPTOMS OF LYMPHOMA
 HODGKIN LYMPHOMA
• Hodgkin lymphoma (HL) is a type of lymphoma in
which cancer originates from a specific type of
white blood cells called lymphocytes. The disease
spreads by contiguous extension along the
lymphatic system.
• The malignant cell of Hodgkin lymphoma is the
Reed-Sternberg cell, a gigantic tumor cell that is
morphologically unique and thought to be of
immature lymphoid origin.
• Reed-Sternberg cells are large, abnormal
lymphocytes that may contain more than one
nucleus
 CAUSES

The exact cause of Hodgkin lymphoma is not known, but the following have been
implicated:
• Viruses: The Epstein-Barr virus, the same virus that causes infectious mononucleosis
(mono), has been implicated as a cause of Hodgkin lymphoma. The presence of the
genome of this virus is seen in 20%-80% of Hodgkin lymphoma tumors.
• Familial: Same-sex siblings and an identical twin of a person with Hodgkin lymphoma
are at high risk of developing the disease. Children with a parent who has Hodgkin is
also at an increased risk.
• Environment: Fewer siblings, early birth order, single-family homes, and fewer
playmates are associated with an increased risk of developing Hodgkin lymphoma --
possibly due to a lack of exposure to bacterial and viral infections at an early age.
 SYMPTOMS
• The most common symptom of HD is swelling of the lymph nodes, which causes a lump
to form under the skin. This lump usually isn’t painful. It may form in one or more of the
following areas: (1) on the side of the neck, (2) in the armpit or (3) around the groin
Other symptoms of HD include:
• night sweats
• itchy skin
• fever
• fatigue
• unintended weight loss
• persistent cough, trouble breathing, chest pain
• pain in the lymph nodes after consuming alcohol
• enlarged spleen
 TREATMENT

Treatment for HD typically depends on the stage of the disease. The main treatment
options are chemotherapy and radiation.
• Radiation therapy uses high-energy beams of radiation to destroy cancer
cells. Chemotherapy involves the use of medications that can kill cancer cells.
Chemotherapy drugs may be given orally or injected through a vein, depending on
the specific medication.
• Immunotherapy or a stem cell transplant may also be used if you don’t respond
to chemotherapy or radiation. A stem cell transplant infuses healthy cells called
stem cells into your body to replace the cancerous cells in your bone marrow.
• After treatment, your doctor will want to follow up with you on a regular basis. Be
sure to keep all your medical appointments and follow your doctor’s instructions.
 NON-HODGKIN LYMPHOMA

• Non-Hodgkin lymphoma is further classified into a variety of subtypes

based on the cell of origin (B-cell or T-cell), and the cell
characteristics. The subtype of Non-Hodgkin lymphoma predicts the
necessity of early treatment, the response to treatment, the type of
treatment required, and the prognosis.
• Non-Hodgkin lymphoma is much more common than Hodgkin
lymphoma. The risk of developing non-Hodgkin lymphoma increases
with age and it is more common in males than in females and in
Caucasians.
STAGES OF NON- HODGKIN
LYMPHOMA
 CAUSES

• Non-Hodgkin’s lymphoma can occur at nearly any age but it most

common among older adults.
Non-Hodgkin’s lymphoma risk factors include:
weakened immune system
exposure to some chemicals
chronic Helicobacter pylori infection
previous radiation or chemotherapy
autoimmune diseases
 SYMPTOMS

• Non-Hodgkin lymphoma can cause lymph nodes to become enlarged.

Enlarged lymph nodes close to the surface of the body (such as on the sides of
the neck, in the groin or underarm areas, or above the collar bone), may be
seen or felt as lumps under the skin. These are usually not painful. 
• Fever
• Night Sweats
• Unintended weight loss
• Itching
• Feeling tired/fatigue.
• Anorexia or loss of appetite.
 TREATMENT

• Treatments are based on the type of non-Hodgkin lymphoma diagnosed, its

stage, and the symptoms present, if any.
• The goal of treatment is to eradicate the lymphoma while causing as little
damage as possible to normal cells to minimize the side effects of treatment.
Talk with your doctor about any treatment related side effects.
• The most common treatments for non-Hodgkin's lymphoma include:
Chemotherapy (drugs), Radiation, Immunotherapy, including monoclonal
antibodies, Stem Cell Transplant, and Surgery, in rare cases.
• These treatments may be used in combination or alone, depending on the
type, stage, and symptoms of the non-Hodgkin lymphoma
REFERENCES