Anaplastic Large T / Null-Cell Lymphoma

Introduction

Anaplastic large T/null-cell lymphoma is a non-Hodgkin lymphoma. It is a very rare condition seen in less than 5 percent of patients; as per risk factors that evolve, this lymphoma is not known completely, but it is seen that the Epstein-Barr virus is involved in many cases. It is a cancer that is formed from the T-cells called white blood cells in the blood. This topic describes anaplastic large T cell lymphoma and its symptoms, different types, and treatment.

What Is an Anaplastic Large T-Cell Lymphoma?

Anaplastic large T cell lymphoma is one of the non-Hodgkin lymphomas. It is a very rare and serious type of cancer. It is cancer that develops from the white blood cells, which are also called lymphocytes. There are two types of lymphocytes one is T lymphocytes (a white blood cell type that develops from bone marrow’s stem cells and helps fight infections), and other is B lymphocytes (an immune system component that develops from the stem cells found in bone marrow). When these lymphocytes start growing abnormally and uncontrollably, then they can cause a condition called cancer of lymphocytes, which is well known as non-Hodgkin lymphoma. As these lymphocytes provide immunity to the body; when these cells become cancerous, they lead to low immunity. Mostly the condition takes place along with T-lymphocytes, which name the condition T-cell lymphoma. It got its name, anaplastic large T-cell lymphoma, as these T-cells appear large under the microscope. The name anaplastic is due to the cancer cells present in it, and T-cells appear in a larger size than their original size as they are abnormal cancerous cells. It has the name lymphoma because it has shown more abnormal growth than normal white cells.

What Are the Different Types of Anaplastic Large T-Cell Lymphoma?

There are different types of anaplastic large-cell lymphoma. The differences in these lie in their location and the type of cancer cell involved. They are:

Systemic Anaplastic Large T-Cell Lymphoma:

It occurs, if there are mutations (changes in gene sequencing) in the anaplastic lymphoma kinase gene (it is a gene that produces proteins that are responsible for cell growth). When these genes are mutated, they cannot instruct the cells to perform the function properly for which they have been destined. There are basically two further types of variation to it.

1. Primary Systemic Anaplastic Large T-Cell Lymphoma or Anaplastic Lymphoma Kinase Positive: It occurs when the mutation on the anaplastic lymphoma kinase gene is present. It evolves fast and aggressively, especially in children and younger adults. These lymphomas can be easily treated by chemotherapy.

2. Anaplastic Lymphoma Kinase-Negative: It occurs when there is no mutation of the gene, but it is also aggressive and has a target population of older adults who are over 60 years of age. The main focus lies here in the treatment of this lymphoma which goes on chemotherapy but has a chance of returning. It is more difficult to treat.

Primary Cutaneous Anaplastic Large T-Cell Lymphoma:

It has shown slower growth than systemic ones. It presents skin conditions like rash or bumps. And mostly, it retains its roots on the skin. It can be acquired by both men and women, usually in people above 40 years of age.

Breast Implant-Associated Anaplastic Large T Cell Lymphoma:

It is usually acquired after breast implant procedures. It affects the female population in their 50s.

What Are the Symptoms Related to Anaplastic Large-Cell Lymphoma?

Different lymphoma has different symptoms associated with them, and they are:

Systemic Anaplastic Large Cell Lymphoma:

• Swollen lymph nodes.

• Fever.

• Fatigue.

• Night sweats.

• Weight loss.

• Common sites are the neck, underarms, and groin.

• Spreading to other body parts can result in chest pain and cough.

Primary Cutaneous Anaplastic Large T-Cell Lymphoma:

• Common sites are the face, abdomen, arms, and legs.

• Usually expresses a single abnormal growth pattern.

• It can show multiple growths over a single area.

• Unusual and abnormal redden growth over the area.

• Elevated and large-shaped bumps.

• Ulcer formation.

Breast-Implant Anaplastic Large T-cell Lymphoma:

• Breast pain.

• Breast swelling.

• Skin rashes.

• Lump over the implanted breast.

• Swelling with fluid accumulation over the implants.

• Mostly associated with a single breast, but both breasts can also be involved.

How to Diagnose Anaplastic Large T-cell Lymphoma?

A doctor uses various methods to be sure about the lymphoma after performing the physical examination. Different measures to diagnose lymphoma are:

• Blood Test: The doctor will recommend the patients to go for a complete blood count (CBC) to check the count of RBC (red blood cell), WBC (white blood cell containing lymphocytes), and platelets levels in the blood. The doctor can also check for the enzyme levels and tumor markers present in the blood.

• Imaging: The doctor goes for other means like chest X-rays, CT (computerized tomography)-scan, MRIs (magnetic resonance imaging), or breast ultrasounds. All these can help to identify the cancer’s location. The PET (positron emission tomography) scan is also an opinion in cases to know the spreading of cancer throughout the body.

• Biopsy: It is ideally performed to confirm the presence of anaplastic large T-cell lymphoma. It is performed by taking a small sample from a cancerous growth region and examining it under a microscope.

What Is the Treatment for Anaplastic Large T-Cell Lymphoma?

There are mainly two scopes for treatment: one is chemotherapy, and the other is surgery.

• Systemic Anaplastic Large T-Cell Lymphoma: These lymphomas are treated with chemotherapy. Chemotherapy destroys cancer cells. In chemotherapy, there are a set of drugs used to kill cancer cells. Some of the drug sets used in chemotherapy are Brentuximab vedotin, Cyclophosphamide, Doxorubicin, and Prednisolone (BV-CHP) If recurrence still occurs, then the doctor can recommend the patient for a stem cell transplant.

• Primary Cutaneous Anaplastic Large T-Cell Lymphoma: It can be treated by radiation therapy and surgery. Along with radiation therapy, the patient may need other additional drugs for a better outcome. Some of them are Interferon for immunity and Methotrexate to treat lymphoma.

• Breast Implant-Associated Anaplastic T Cell Lymphoma: They are treated by removing the breast implants or requiring radiation therapy or chemotherapy to treat the lymphoma.

Conclusion:

Anaplastic large T-cell lymphoma is a serious type of condition; it needs good treatment on time to increase the survival rate of the patient. And, a patient who is associated with these conditions has low immunity. Although the surgery and chemotherapy are the treatment of choice, chances of recurrence also need to be considered. The treatment is usually chemotherapy or radiation therapy, along with surgery. Furthermore, with timely diagnosis and proper treatment the life span of the patient can be improved.