T-cell lymphoma is a type of lymphatic cancer that starts in the T lymphocytes (T cells), a type of white blood cell.
T lymphocytes (T cells) and B lymphocytes (B cells) are two types of white blood cells that perform immune functions in the lymphatic system. B-cells produce antibodies to attack bacteria and viruses that enter the body. T cells directly attack foreign invaders and cancer cells and produce chemicals that activate other immune cells.
Lymphoma, a cancer of the lymphatic system, is grouped into two major types—Hodgkin's and non-Hodgkin's. Hodgkin's lymphoma is a B-cell lymphoma.
Non-Hodgkin's lymphoma is further divided into over 60 subtypes. B-cell lymphomas are the most common type of lymphoma. More than 90% of non-Hodgkin's lymphomas in people in Western countries are B cell in origin. T-cell lymphoma is less common, with about 10% of non-Hodgkin's lymphomas starting in T cells (although this is higher in Asia).
This article will review the types of T-cell lymphomas, why they develop, as well as how they are diagnosed and treated.
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Types of T-Cell Lymphoma
Multiple types of T-cell lymphoma exist, some of which are slow growing (indolent) and others of which grow much more quickly and are more aggressive. All T-cell lymphomas are rare. Some examples of different T cell lymphomas include:
- T-lymphoblastic lymphoma/leukemia: This type most commonly occurs in teens or young adults. It starts in the thymus gland, a lymphatic organ in the chest. It is an aggressive cancer but curable if caught early.
- Cutaneous T cell lymphomas (mycosis fungoides, Sezary syndrome): These T-cell lymphomas start in the skin, and can have a rash-like appearance that spreads across the body. Initially, they may be indolent lymphomas but can become aggressive and move to internal organs.
- Adult T-cell lymphoma/leukemia: This lymphoma is caused by a virus and is most common in areas of the world such as Japan, Africa, and the Caribbean. It has different types that can be aggressive or indolent.
- Extra-nodal natural killer/T-cell lymphoma, nasal type: This is an aggressive lymphoma most commonly found in Asian and Hispanic populations and is very aggressive. It usually starts in the sinuses or nasal passages.
- Enteropathy-associated intestinal T-cell lymphoma: Most common in Europeans, this lymphoma starts in the intestines. It may be more likely in those who are intolerant to gluten.
- Anaplastic large-cell lymphoma: This lymphoma is more likely to be seen in children and younger adults. It can be aggressive but is curable.
What's the Difference Between Leukemia and Lymphoma?
Both leukemia and lymphoma are blood cancers. Some key differences between lymphoma and leukemia are the location in which the cancer starts and where the cancer cells are found. Leukemia starts in the cells that produce blood cells in the bone marrow. The cancerous cells can be found circulating in the bloodstream. They may be lymphocytic cells or come from other lines of blood cells.
Lymphocytes are produced in the bone marrow but after release are found throughout the lymphatic system (such as in the lymph nodes and spleen). In lymphoma, cancerous changes start in lymphocytes in the lymphatic system and can spread elsewhere in the body. The cancerous cells generally do not develop in the bloodstream.
There is some overlap in the definitions for some subtypes, such as T-lymphoblastic lymphoma/leukemia and adult T-cell lymphoma/leukemia.
Causes
Lymphoma develops when the DNA inside of the T-cell lymphocyte becomes abnormal, and those abnormal cells begin to divide into more abnormal cells. The exact trigger of this change in the DNA is often unknown, but some theories exist.
Factors that may be responsible for affecting the DNA of the cells include:
- Exposure to ultraviolet (UV) rays
- Chemical exposure
- Radiation exposure
- Viral infections
- Bacterial infections
- Stress
- Poor diet
- Spontaneous
- Inherited factors
Symptoms
Symptoms differ among the types of lymphoma. Symptoms of T-cell lymphoma can include:
- Enlarged lymph nodes
- Fever
- Chills
- Drenching night sweats
- Frequent infections
- Itchy skin rash
- Easy bleeding, bruising
- Unintentional weight loss
- Shortness of breath or cough
- Red or purple bumps on the skin
Diagnosis
The diagnosis of lymphoma often starts with a physical exam from a healthcare provider. During the exam, the provider can evaluate for the presence of any enlarged lymph nodes or other abnormal findings.
Differences in Lymphoma Occurrence
Some lymphomas, such as T-lymphoblastic lymphoma/leukemia are more common in men than women and in teens or young adults than older adults. Other lymphomas, such as peripheral T-cell lymphoma, are more often diagnosed later in life, usually in the 60s.
Biopsy
A biopsy will determine if cancer is present. During a biopsy, a sample of the suspicious area is removed for testing. Specialized lab testing is performed by a pathologist (a specialist in laboratory medicine) to determine the type of cancer cells present.
Imaging Studies
Imaging studies, such as computerized tomography (CT), positron-emission tomography (PET) scan, magnetic resonance imaging (MRI), or ultrasound, are used to determine the exact location in the body where cancer is located.
When reviewed in combination with the biopsy results, imaging determines the stage of the lymphoma, which defines how far the cancer has spread.
Treatment
Treatment will be determined by the oncologist (specialist in cancer) treating the lymphoma. Treatment is based on the type of T-cell lymphoma and its stage.
Treatment options can include chemotherapy, radiation, monoclonal antibodies, and stem cell transplant. Some forms ofT-cell lymphoma, especially if it is slow growing, may not receive any treatment.
Chemotherapy
Chemotherapy is medication that is given to keep cancer cells from continuing to grow. It is typically given in combinations of different medications and is most often given through an intravenous (IV) infusion (through a line into a vein). Other forms of chemotherapy include topical preparations (applied to the skin), pills, or given into the cerebrospinal fluid (intrathecally).
Radiation
Radiation treatment uses high-energy beams to damage the DNA in the cancer cells, which causes cell death and prevents the cells from continuing to grow. Radiation treatments are typically given once a day for a period of a few weeks under the direction of a radiation oncologist.
Monoclonal Antibodies
These infusions may be used alone or in combination with chemotherapy. They work by targeting specific proteins on the outside of cells, which can help recruit the immune system to fight off the cancer.
Stem Cell Transplant
Some T-cell lymphomas require high doses of chemotherapy to kill. In killing the cancer cells, the bone marrow, where blood cells are formed, can be killed off as well.
A stem cell transplant infuses healthy stem cells back into the body to be able to create blood cells again. The stem cells can come from a donor or be removed from the patient before chemotherapy.
Prognosis
The type of T-cell lymphoma that someone is diagnosed with will determine the prognosis (outcomes). However, when looking at T-cell lymphomas overall, the estimated five-year survival rate is 63%. This means that for those diagnosed with T-cell lymphoma, approximately 63% were alive five years after diagnosis.
The five-year survival rate for the lymphoma subtypes varies from over 90% for mycosis fungoides to less than 20% for enteropathy-associated intestinal T-cell lymphoma. New drugs and clinical trials are developed and continue to improve the prognosis of T-cell lymphomas.
These survival rates are of people diagnosed at least five years in the past and do not reflect outcomes with newer treatments. Your individual prognosis will also be influenced by the stage at diagnosis, your overall health, other conditions you have, your age, and more.
You need to have an in-depth discussion with your healthcare provider to understand your treatment options, predicted survival, and the chance of a cure or remission.
Summary
T-cell lymphomas are rare cancers of the T cells in the lymphatic system. Multiple types of T-cell lymphomas exist, with some being aggressive and others being slow growing. Depending on the type and other factors, the condition will be treated with chemotherapy, monoclonal antibodies, or simply by observation alone.
A Word From Verywell
Receiving a diagnosis of T-cell lymphoma can be an anxiety-provoking time. It is important to talk to your healthcare team if you have any questions about your diagnosis, treatment plan, or prognosis, as they will have the most accurate information for you.
Frequently Asked Questions
Is T-cell lymphoma curable?
T-cell lymphoma can be curable. The cure rates depend upon the type of T-cell lymphoma someone has and the stage in which it’s diagnosed.
What is the life expectancy of someone with T-cell lymphoma?
(Video) T Cell LymphomaThe life expectancy for someone with T-cell lymphoma depends upon the type of T-cell lymphoma and the stage in which it’s diagnosed. When looking at T-cell lymphomas overall, though, the five-year survival rate is about 63%.
What are the early signs of T-cell lymphoma?
The early signs of T-cell lymphoma may include skin changes, lumps in the neck or in the armpits or groin, weight loss, fevers, and night sweats.
(Video) What is T-cell lymphoma?
FAQs
What is T-cell lymphoma caused by? ›
Adult T-cell leukemia/lymphoma may result from an infection with a virus called HTLV-1. It may affect the bone marrow, lymph nodes, spleen, liver, skin and other organs.
How is T-cell lymphoma diagnosed? ›Skin biopsies.
A procedure to cut away a small sample of skin (skin biopsy) is usually needed to diagnose cutaneous T-cell lymphoma. The skin might be cut with a circular tool (punch biopsy). For larger lesions and tumors the biopsy might be done with a small knife (excisional biopsy).
- Round patches of skin that may be raised or scaly and might be itchy.
- Patches of skin that appear lighter in color than surrounding skin.
- Lumps that form on the skin and may break open.
- Enlarged lymph nodes.
- Hair loss.
- Thickening of the skin on the palms of the hands and soles of the feet.
- Alisertib.
- Bendamustine (Treanda)
- Bortezomib (Velcade)
- GDP (gemcitabine, dexamethasone, and cisplatin)
- Lenalidomide (Revlimid)
- Nivolumab (Opdivo)
- Panobinostat (Farydak)
- Pembrolizumab (Keytruda)
T-cell lymphomas are a form of non-Hodgkin lymphoma (NHL) that can develop in lymphoid tissues such as the lymph nodes and spleen, or outside of lymphoid tissues (i.e., gastrointestinal tract, liver, nasal cavity, skin, and others).
What virus is associated with T-cell lymphoma? ›The human T-lymphotropic virus type 1 is also known by the acronym HTLV-1, or as human T-cell leukaemia virus type 1. The virus can cause a type of cancer called adult T-cell leukaemia/lymphoma (ATL). HTLV-1 is transmitted primarily through infected bodily fluids including blood, breast milk and semen.
How serious is T-cell lymphoma? ›These cancers cause symptoms like rash, very itchy skin (pruritus) or other skin issues that may look and feel like common skin disorders. Most cutaneous T-cell lymphomas grow very slowly and aren't life-threatening, but some people may develop serious forms of the condition.
Can a blood test detect T-cell lymphoma? ›In addition to a physical examination, the following tests may be used to diagnose T-cell leukemia: Blood tests. The diagnosis of T-cell leukemia begins with a blood test called a complete blood count (CBC). A CBC measures the numbers of different types of cells in the blood.
Does lymphoma show up in blood work? ›Blood Tests for Lymphoma
Blood tests are essential to accurately diagnosing this complex disease. These tests can show whether you have lymphoma cells or abnormal levels of normal cells: Blood smear: We take a drop of blood and look at it under a microscope.
In stage 1, raised, red patches called plaques may appear on the skin. If less than 10% of the skin is affected, the cancer is classified as stage 1A. Stage 1B describes plaques that cover more than 10% of the skin.
How long do T-cell lymphoma patients live? ›
Overall, people with non-Hodgkin lymphoma (including T-cell lymphoma along with other types) have a five-year RS of 66.9 percent. Those with T-cell NHL specifically have a slightly lower survival rate of 63.1 percent. Survival may be further broken down by type of T-cell NHL.
What is the number one symptom of lymphoma? ›The most common sign of lymphoma is a lump or lumps, usually in the neck, armpit or groin. These lumps are swollen lymph nodes, sometimes known as 'glands'. Usually, they're painless.
Is T-cell lymphoma curable? ›T-cell lymphoma is not curable but it is treatable. Yale Medicine's Department of Dermatology offers expert, multidisciplinary care and advanced treatments, including phototherapy for this unusual type of lymphoma.
What is natural killer T-cell lymphoma? ›Natural killer/T-cell lymphoma (NKTL) is a sub-type of Epstein–Barr virus (EBV)-related non-Hodgkin lymphomas common in Asia and Latin America but rare elsewhere. Its pathogenesis is complex and incompletely understood. Lymphoma cells are transformed from NK- or T-cells, sometimes both.
What does T-cell lymphoma rash look like? ›There are several ways cutaneous T cell lymphoma can appear. In its early stages, it can look like flaky, dry skin, so it's often mistaken for eczema. It can also appear scaly like psoriasis and even as blisters on the skin. As the disease progresses, it can continue to develop into thicker patches known as plaques.
Is T-cell lymphoma hard to diagnose? ›It can take time to diagnose cutaneous T-cell lymphoma (CTCL). This cancer is rare. If you have early CTCL, it can be difficult to find because: CTCL often looks like a common skin condition, such as eczema or psoriasis.
What disease attacks T cells? ›Chronic T-cell leukemia (T-cell prolymphocytic leukemia): A blood cancer that starts in your T-cells that can affect your bone marrow, blood and lymph nodes. DiGeorge syndrome: A genetic disorder that can prevent your body from making enough healthy T-cells.
What disease is associated with T cells? ›T-cell immunodeficiency diseases include severe combined immunodeficiencies (SCIDs), Wiskott-Aldrich syndrome, ataxia telangiectasia, DiGeorge syndrome (22q11. 2 deletion syndrome), immuno-osseous dysplasias, dyskeratosis congenita, and chronic mucocutaneous candidiasis.
Is T-cell lymphoma and autoimmune disease? ›Abstract. Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive malignancy with a presentation like either autoimmune diseases, drug reactions, or infections.
What is another name for T-cell lymphoma? ›Most T-cell lymphomas are non-Hodgkin lymphomas. There are many different types of T-cell non-Hodgkin lymphomas. These include mycosis fungoides, anaplastic large cell lymphoma, and precursor T-lymphoblastic lymphoma. Prognosis and treatment depend on type and stage of the cancer.
Does T-cell lymphoma affect the brain? ›
Involvement of deep brain structures (basal ganglia, corpus callosum, brainstem, and/or cerebellum) occurs in 30%–36% of cases (4). The incidence of ocular involvement is low in PCNSTCL (4). Multiple lesions are diagnosed in 29%–56% of patients (4). Secondary CNS T-cell lymphoma at presentation is rare.
Can a CBC tell if you have lymphoma? ›In cancer care, a CBC is used to: Help diagnose some blood cancers, such as leukemia and lymphoma.
How common is T-cell lymphoma? ›T-cell lymphomas are the uncommon and rare subtype of non-Hodgkin lymphomas. This disease group has a poor prognosis compared to their B-cell counterpart.
What labs are abnormal with lymphoma? ›Blood Tests
A low level of red blood cells, white blood cells or platelets may indicate that the lymphoma is present in the bone marrow and/or blood.
Swollen lymph nodes, fever, and night sweats are common symptoms of lymphoma. Symptoms of lymphoma often depend on the type you have, what organs are involved, and how advanced your disease is. Some people with lymphoma will experience obvious signs of the disease, while others won't notice any changes.
Is WBC high or low with lymphoma? ›Some people with NHL have lymphoma cells in their bone marrow when they are diagnosed. This can cause low blood cell counts, such as: low red blood cell counts (anaemia), causing tiredness and sometimes breathlessness. low white blood cell counts, increasing your risk of getting infections.
What diagnostic test confirms lymphoma? ›A bone marrow aspiration and biopsy procedure involves inserting a needle into your hipbone to remove a sample of bone marrow. The sample is analyzed to look for lymphoma cells. Imaging tests. Your doctor may recommend imaging tests to look for signs of lymphoma in other areas of your body.
How fast does T-cell lymphoma progress? ›Cutaneous T-cell lymphoma is usually a slow-growing cancer. It develops over many years. The 2 most common types of this cancer are mycosis fungoides and the Sezary syndrome.
Is Stage 4 T-cell lymphoma curable? ›The survival rate of stage 4 lymphoma is lower than that of the other stages, but doctors can cure the condition in some cases. People with a diagnosis of stage 4 lymphoma should discuss their treatment options and outlook with their doctor.
What is Stage 4 T-cell lymphoma? ›Stage 4. Stage 4 is the most advanced stage of lymphoma. Lymphoma that has started in the lymph nodes and spread to at least one body organ outside the lymphatic system (for example, the lungs, liver, bone marrow or solid bones) is advanced lymphoma.
How bad is chemo for lymphoma? ›
Skin reactions are common. Chemotherapy kills cells that multiply quickly, such as lymphoma cells. It also causes damage to fast-growing normal cells, including hair cells and cells that make up the tissues in your mouth, gut and bone marrow. The side effects of chemotherapy occur as a result of this damage.
Can T-cell lymphoma go into remission? ›Success Rate of CAR T-Cell Therapy in Phase I Clinical Trial
Patients with refractory disease had cancer that did not respond to treatment at all. Within 28 days of being treated with CAR T-cell therapy, 82% of trial patients responded positively – with more than half of them still in remission six months later.
This uncontrolled growth may form a tumor, involve many parts of the lymphatic system, or spread to other parts of the body. Hodgkin lymphoma most commonly affects lymph nodes in the neck or in the area between the lungs and behind the breastbone, which is called the mediastinum.
What illness can be mistaken for lymphoma? ›- Influenza.
- Hodgkin's lymphoma.
- Cat scratch fever.
- HIV.
- Infections.
- Mononucleosis.
NHL is a disease that usually comes on suddenly and gets worse quickly. Symptoms vary depending on where tumor(s) are. These are the most common locations and their symptoms: Abdomen – pain, swelling, fever, anemia, tiredness, weight loss, vomiting, diarrhea, constipation, and irregular periods.
What are the advanced stages of T-cell lymphoma? ›Stages IIB through IVB are considered advanced-stage disease, where the cancer is more widespread and/or has moved outside the skin to other places in the body such as the lymph nodes or other organs.
What is the most aggressive T-cell lymphoma? ›Angioimmunoblastic T-cell lymphoma
Angioimmunoblastic lymphoma (AITL) is a rare type of non-Hodgkin lymphoma (NHL). It is a high grade (aggressive) lymphoma that affects blood cells called T cells.
Non-Hodgkin lymphoma is usually treated with chemotherapy or radiotherapy, although some people may not need treatment straight away. In a few cases, if the initial cancer is very small and can be removed during a biopsy, no further treatment may be needed.
What antibody kills lymphoma cells? ›Rituximab (Rituxan) is the monoclonal antibody that doctors most often use to treat lymphoma. This drug targets the CD20 antigen, which many types of lymphoma make too much of. CD20 is found on a type of white blood cell called a B cell.
Is T-cell lymphoma genetic? ›The most prevalent clinical forms of CTCL are mycosis fungoides (MF) and the more aggressive leukemic variant, Sézary syndrome (SS). Although the etiology is largely unknown, some lines of evidence indicate that genetic factors and heredity play a role in CTCL.
What do lymphoma skin spots look like? ›
Many types of CTCL start as flat red patches on the skin, which can sometimes be itchy. With darker skin, the patches may appear lighter or darker than the surrounding skin. In the early stages, the skin patches can look like other common conditions such as eczema or psoriasis.
What do lymphoma bumps look like? ›When a rash caused by skin lymphoma (also referred to as cutaneous lymphoma) is in its early stages, it often presents as small patches of dry, red skin on the torso, buttocks or another area of the body. At this stage, the rash often resembles dermatitis, eczema or psoriasis.
Does T-cell lymphoma itch? ›Cutaneous T-cell lymphoma can cause excessively dry skin, itch, and serious skin infections, which a dermatologist often treats.
What are the chances of surviving T-cell lymphoma? ›Overall, people with non-Hodgkin lymphoma (including T-cell lymphoma along with other types) have a five-year RS of 66.9 percent. Those with T-cell NHL specifically have a slightly lower survival rate of 63.1 percent. Survival may be further broken down by type of T-cell NHL.
Does T-cell lymphoma go away? ›T-cell lymphoma is not curable but it is treatable. Yale Medicine's Department of Dermatology offers expert, multidisciplinary care and advanced treatments, including phototherapy for this unusual type of lymphoma.
Is T-cell lymphoma fatal? ›Cutaneous T-Cell Lymphoma is a form of cancer that causes immune system dysfunction that leads to skin health concerns. Like other forms of cancer, Cutaneous T-Cell Lymphoma can be deadly, especially if the condition goes untreated until it reaches the advanced stages.
What is the average age for T-cell lymphoma? ›The incidence of T-cell lymphoma increases with advancing age. Geographic location and ethnic variability have an impact on the distribution of the disease. The usual age group of PTCL is between 55 to 74yrs at the time of diagnosis and are more common in males.
What is Stage 1 T cell lymphoma? ›In stage 1, raised, red patches called plaques may appear on the skin. If less than 10% of the skin is affected, the cancer is classified as stage 1A. Stage 1B describes plaques that cover more than 10% of the skin.
Where do you itch with lymphoma? ›Itching caused by lymphoma can affect: areas of skin near lymph nodes that are affected by lymphoma. patches of skin lymphoma. your lower legs.
What does T cell lymphoma rash look like? ›There are several ways cutaneous T cell lymphoma can appear. In its early stages, it can look like flaky, dry skin, so it's often mistaken for eczema. It can also appear scaly like psoriasis and even as blisters on the skin. As the disease progresses, it can continue to develop into thicker patches known as plaques.
Which is worse B cell or T-cell lymphoma? ›
Hence T-cell lymphomas are worse than B-cell lymphomas.
Can T-cell lymphoma be misdiagnosed? ›Called indolent T-cell lymphoproliferative disease of the gastrointestinal tract, or indolent T-LPD the disease causes similar lesions in the gastrointestinal tract. In some cases, this disease has been misdiagnosed as lymphoma, and physicians have begun executing lymphoma treatment.
What foods make lymphoma worse? ›Avoid foods that are high in saturated fats from animal products such as meats, butters, and cheeses. Also limit trans fats that are found in processed food cooked in hydrogenated fats. These types of foods include crackers, potato chips, baked goods, and deep-fried fast foods.
Can something trigger lymphoma? ›Causes of lymphoma
In most cases, there is no known cause for lymphoma. However, for a few types of lymphoma, scientists have identified a cause: Most cases of gastric MALT lymphoma are caused by a common bacterial infection called Helicobacter pylori. Usually, Helicobacter pylori causes stomach ulcers and indigestion.
Past studies have found a significantly elevated risk of lymphoma in association with use of antibiotics (3–5), nonsteroidal anti-inflammatory drugs (NSAIDs) and other analgesics (3, 6–8), corticosteroids and other immunosuppressants (3, 6, 9–12), histamine2-receptor antagonists (13, 14), psychotropic drugs (3, 11, 15) ...