Lymphadenopathy is swelling of one or more lymph nodes. It is a recognised symptom of many diseases, which include:
reactive: acute infection (e.g. bacterial, or viral), or chronic infections (tuberculous lymphadenitis, cat-scratch disease). When the infection is of the lymph nodes themselves, it is called lymphadenitis, but when the infection is of the lymph glands, it is called lymphangitis.
tumoral: Hodgkin lymphoma, non-Hodgkin lymphoma, metastasis
unknown etiology: sarcoidosis.
Cancer Immunotherapy is the use of the immune system to reject cancer. The main premise is stimulating the patient's immune system to attack the malignant tumor cells that are responsible for the disease. This can be either through immunization of the patient, in which case the patient's own immune system is trained to recognize tumor cells as targets to be destroyed, or through the administration of therapeutic antibodies as drugs, in which case the patient's immune system is recr ...
Symptoms of WM include weakness, fatigue, weight loss and chronic oozing of blood from the nose and gums. Peripheral neuropathy can occur in 10% of patients. Some of these symptoms are due to the effects of the IgM paraprotein, which may cause autoimmune phenomenon or cryoglobulinemia.
Unique to WM is the occurrence of the hyperviscosity syndrome. This is attributed to the IgM monoclonal protein increasing the viscosity of the blood. Symptoms of this are mainly neurologic and can include blurring or loss o ...
It consists of cyclophosphamide, doxorubicin (under its alternative name hydroxydoxorubicin), vincristine (under its brand name Oncovin®), and prednisone. This regimen can also be combined with the monoclonal antibody rituximab if the lymphoma is of B cell origin. Typically, courses are administered at an interval of three weeks. A staging CT scan is generally performed after three cycles to assess wh ...
Treatment includes the monoclonal antibody rituximab, sometimes in combination with chemotherapy like chlorambucil or cyclophosphamide. Corticosteroids are also used in combination.
Plasmapheresis can be used to treat the hyperviscosity syndrome. Recently, autologous bone marrow transplantation has been added to the available treatment options with good success.
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The combination is generally well tolerated. Chemotherapy-induced nausea and vomiting may require antiemetics (such as ondansetron), and hemorrhagic cystitis is prevented with administration of mesna. Alopecia (hair loss) is common.
Neutropenia generally develops in the second week. During this period, many clinicians recommend prophylactic use of ciprofloxacin[1]. If a fever develops in the neutropenic period, urgent medical assessment is required for neutropenic sepsis, as infections in pa ...
