Understanding Non-Hodgkin Non-Hodgkin …

[Pages:174]Understanding

Non-Hodgkin Lymphoma

A Guide for Patients, Survivors, and Loved Ones

8th Edition Fall 2020

Lymphoma Research Foundation (LRF) Helpline and Clinical Trials Information Service

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Our support services include:

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Understanding

Non-Hodgkin Lymphoma

A Guide For Patients, Survivors, and Loved Ones

Fall 2020

8th Edition

This guide is an educational resource compiled by the Lymphoma Research Foundation (LRF) to provide general information on adult non-Hodgkin lymphoma. This booklet is not intended to replace individualized medical care or the advice of a patient's doctor. Patients are strongly encouraged to talk to their doctors for complete information on how their disease should be diagnosed, treated, and followed. Before starting treatment, patients should discuss the potential benefits and side effects of cancer therapies with their physician.

Contact the Lymphoma Research Foundation Helpline: (800) 500-9976 helpline@

Website:

This patient guide is supported through unrestricted educational grants from:

? 2020 Lymphoma Research Foundation. Information contained herein is the property of the Lymphoma Research Foundation (LRF). Any portion may be reprinted or reproduced provided that LRF is acknowledged to be the source and the Foundation's website () is included in the citation.

ACKNOWLEDGMENTS

The Lymphoma Research Foundation wishes to acknowledge those individuals listed below who have given generously of their time and expertise. We thank them for their contributions, editorial input, and professional knowledge, which have truly enhanced this publication. The review committee guided the content and development of this publication. Without their dedication and efforts, this publication would not have been possible. We hope those in the lymphoma and chronic lymphocytic leukemia community will now be better informed and have a better understanding of these diagnoses because of the gracious efforts of those involved in the planning and execution of this comprehensive disease guide.

Review Committee Editorial Board Steering Committee Editorial Chairman *Morton Coleman, MD, FACP, NewYork-Presbyterian Hospital/ Weill Cornell Medicine

Medical Review Board

Jeremy S. Abramson, MD, FACP, Massachusetts General Hospital/Harvard Medicine

Nancy L. Bartlett, MD, Washington University School of Medicine

*Bruce D. Cheson, MD, FACP, FAAAS, FASCO, Lombardi Comprehensive Cancer Center/Georgetown University Hospital

*Kieron M. Dunleavy, MD, GW Cancer Center/George Washington University

David R. Freyer, DO, MS, Children's Hospital Los Angeles and USC Norris Comprehensive Cancer Center

*Leo I. Gordon, MD, FACP, Robert H. Lurie Comprehensive Cancer Center of Northwestern University

ii Understanding Non-Hodgkin Lymphoma

*Thomas M. Habermann, MD, Mayo Clinic, Rochester, MN *Brad S. Kahl, MD, Washington University Medical School *Ann S. LaCasce, MD, MMSc, Dana-Farber Cancer Institute/ Harvard Medicine *John P. Leonard, MD, NewYork-Presbyterian Hospital/Weill Cornell Medicine *Peter Martin, MD, NewYork-Presbyterian Hospital/Weill Cornell Medicine John M. Pagel, MD, PhD, Center for Blood Disorders and Transplantation/Swedish Cancer Institute Lauren C. Pinter-Brown, MD, FACP, Chao Family Comprehensive Cancer Center/University of California at Irvine Pierluigi Porcu, MD, Sidney Kimmel Cancer Center/Jefferson Health

Lymphoma Research Foundation Reviewers

Victor Gonzalez, Associate Director of Support Resources and Strategic Partnerships Meghan Gutierrez, Chief Executive Officer Sarah Quinlan, Senior Director of Programs and Strategy Izumi Nakano, Associate Director of Support Services Uchenna Esomonu, Support Services Coordinator

*Member of LRF Scientific Advisory Board (SAB), which is comprised of 45 world-renowned lymphoma experts who seek out the most innovative and promising research projects for support.

Understanding Non-Hodgkin Lymphoma iii

TABLE OF CONTENTS

Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Part 1 -- Learning the Basics. . . . . . . . . . . . . . . . . . . . . . . . . 8

Chapter 1: Understanding the Disease. . . . . . . . . . . . . . . . . . . . 8 Table 1.1. Main Types of Indolent and Aggressive NHLs (Listed Alphabetically). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Chapter 2: Seeking Medical Attention. . . . . . . . . . . . . . . . . . . . 30 Table 2.1. Signs and Symptoms Commonly Found in Patients With NHL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Chapter 3: Receiving a Diagnosis. . . . . . . . . . . . . . . . . . . . . . . 35 Table 3.1. The Three Main Types of Biopsies. . . . . . . . . . . . . 37 Table 3.2. Immunohistochemistry and Flow Cytometry Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Chapter 4: Work-Up Before Treatment Can Begin. . . . . . . . . . 45 Table 4.1. The Eastern Cooperative Oncology Group (ECOG) Performance Status Scale. . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Table 4.2. Types of Imaging Tests. . . . . . . . . . . . . . . . . . . . . . 48 Table 4.3. Other Types of Biopsies. . . . . . . . . . . . . . . . . . . . . 50

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Part 2 -- Treatment of Non-Hodgkin Lymphoma. . . . . 55

Chapter 5: What to Know Before Starting Treatment . . . . . . . 55 Table 5.1. International Prognostic Index for Diffuse Large B-Cell Lymphoma and NHL. . . . . . . . . . . . . . . . . . . . . . . . . . . 58

Chapter 6: Treatments for Non-Hodgkin Lymphoma. . . . . . . . 69 Table 6.1. Common Chemotherapy Regimens for NHL . . . . 73 Table 6.2. Catheters Used to Administer Drug Treatments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Table 6.3. Methods for Delivering Radiation Therapy . . . . 100 Table 6.4. Terms Used to Describe Treatment and Its Outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Table 6.5. Forms of Complementary Therapy. . . . . . . . . . . 110

Part 3 -- Survivorship and Living With the Side Effects of Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . 112

Chapter 7: Common Treatment Side Effects . . . . . . . . . . . . . 112 Table 7.1. Five Common Conditions Caused by Decreased Blood Cell Production . . . . . . . . . . . . . . . . . . . . 115

Chapter 8: Managing Life During and After Treatment. . . . . 142 Table 8.1. Coping Strategies. . . . . . . . . . . . . . . . . . . . . . . . . 142

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Part 4 -- Hospital Admission. . . . . . . . . . . . . . . . . . . . . . . 148

Chapter 9: Preparing to Go to the Hospital. . . . . . . . . . . . . . . 148

Part 5 -- Clinical Trials and Advances in Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155

Chapter 10: Overview of Clinical Trials. . . . . . . . . . . . . . . . . . 155 Table 10.1. The Four Phases of Clinical Trials. . . . . . . . . . . 156

Chapter 11: Advances in Treatment of Patients With Non-Hodgkin Lymphoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 About The Lymphoma Research Foundation . . . . . . . . . . . . . . 166

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