Lymphoma is a group of cancers originating in the lymphatic system, which helps the body fight infection and disease.
The following represent symptoms typical for a variety of lymphomas:
•Enlargement of lymph nodes, spleen, or other immune tissue
•Unexplained Fever
•Unexplained weight loss
•Itching skin
•Fatigue
•Night sweats
Hodgkin lymphoma is distinguished from other lymphatic cancers by the presence of a Reed-Sternberg cell, a large malignant cell in the lymph node.
Mo Ziari, M.D is here to discuss Hodgkin’s Lymphoma, how is it different from non-Hodgkin’s, and what are the signs and symptoms you should look for that might send up a red flag.
Selected Podcast
Understanding Hodgkin’s Lymphoma
Featured Speaker:
Dr. Ziari completed his undergraduate degree in Shiraz, Iran, at Shiraz University of Medical Sciences. Following medical school, he completed his residency at Saint Louis University, and later he completed his fellowship in Dallas at the University of Texas Southwestern.
Dr. Ziari is board certified in hematology and oncology, and is an accomplished and experienced clinician and clinical researcher. He has particular interest in breast and lung malignancies. He has written peer-reviewed publications and has presented at national meetings. Dr. Ziari sees the full spectrum of cancers in adults.
Learn more about Mo Ziari, M.D
Mo Ziari, MD
Mo Ziari, M.D., is a clinical assistant professor in the Department of Hematology & Hematopoietic Cell Transplantation and Department of Medical Oncology & Therapeutics Research at City of Hope Corona. Prior to joining City of Hope, he was at Wilshire Oncology/US oncology for four years.Dr. Ziari completed his undergraduate degree in Shiraz, Iran, at Shiraz University of Medical Sciences. Following medical school, he completed his residency at Saint Louis University, and later he completed his fellowship in Dallas at the University of Texas Southwestern.
Dr. Ziari is board certified in hematology and oncology, and is an accomplished and experienced clinician and clinical researcher. He has particular interest in breast and lung malignancies. He has written peer-reviewed publications and has presented at national meetings. Dr. Ziari sees the full spectrum of cancers in adults.
Learn more about Mo Ziari, M.D
Transcription:
Understanding Hodgkin’s Lymphoma
Melanie Cole (Host): For people who are diagnosed with lymphoma, the Tony Stevenson lymphoma Center at City of Hope is one of the biggest and most successful treatment centers in the nation. Because of the vast experience in treating patients with lymphoma, the specialists there lead the field of hematopoietic cells transplantation with excellent outcomes. My guest today is Dr. Mo Ziari. He is Clinical Assistant Professor in the Department of Hematology and Hematopoietic Cell Transplantation and the Department of Medical Oncology and Therapeutics Research at City of Hope. Welcome to the show, Dr. Ziari. So, tell us a little bit about Hodgkin's lymphoma. We hear about non-Hodgkin’s. What is the difference between those two?
Dr. Mo Ziari (Guest): Good morning. The two main type of lymphoma are Hodgkin's lymphoma and non-Hodgkin's lymphoma, which are classified by certain unique characteristics of the cancer cell. So, for example, in Hodgkin's lymphoma you may see a reed sternberg cell, but in non-Hodgkin’s lymphoma which have a lot of different types, you may see different type of cell.
Melanie: And what would somebody notice? Lymphoma, being a blood disease, what would people notice as symptoms of something that would send them a red flag to go see a doctor?
Dr. Ziari: Well, people may see a swelling of the lymph node and drenching night sweat, weight loss--significant weight loss--and loss of appetite, sometimes itching and significant other symptoms. It depends if swelling lymph node is adjacent to an organ, it can cause organ damage as well.
Melanie: Are there certain risk factors? Is there a genetic component to Hodgkin's lymphoma?
Dr. Ziari: Well, there are some risks actually for this. One of them is a virus. We know Epstein-Barr virus has a significant role. The virus that cause infectious mono, and in lymphoma cells, they notice the presence of them in about 20% to 80%. The other risk factor is familial. So, we have seen this in same sex siblings and the identical twin of a person with Hodgkin's lymphoma are at high risk of developing the disease. Children with parents who have Hodgkin's are also at increased risk. The other thing is environment. So, fewer siblings, early birth order, single family home and fewer playmates are associated with increased risk of developing a Hodgkin's lymphoma, possibly due to lack of exposure to bacterial and viral infections at an early age.
Melanie: Wow! So people hear the word lymphoma--very scary, Dr. Ziari. If they had to choose, which is the preferable cancer? Hodgkin's or non-Hodgkin’s? Which one is more easily treatable?
Dr. Ziari: Well, now we have a lot of progress. Now, we have a lot of treatment for them but Hodgkin's lymphoma has a better prognosis with a very good success rate compared to non-Hodgkin's lymphoma. Again, it depends on the type of what type of non-Hodgkin's lymphoma--if it is aggressive or non-aggressive. But, in general, Hodgkin's lymphoma has a better prognosis.
Melanie: And what are some of the treatment options? What can you do for people that have been diagnosed?
Dr. Ziari: Well, a lot. As I mentioned, we a lot of good treatments available for Hodgkin's lymphoma. If they are at an earlier stage, they may require few chemotherapies plus/minus some radiation therapy. If they are more advanced and high risk, they may have to get more chemotherapy compared to earlier stage plus radiation therapy. There is some favorable risk and some non-favorable risk that we categorize based on this. Some blood work, for example if a patient is anemic, typically males, have a worse prognosis compared to females, aged more than 45, those patients with higher stages, meaning that more lymph nodes involvement and also bone marrow involvement, higher blood count also have a poor risk. And so, we stratify this based on a good risk, fair risk and poor risk. So, definitely poor risk has less response and good risk has a much better response.
Melanie: What are we looking at, at the horizon picture, Dr. Ziari, for lymphomas of all types? Because there are a few types of lymphoma and what are you seeing as going on in the future and the exciting new developments?
Dr. Ziari: Well, definitely there is a very, very good horizon for this such as immunotherapy. It's now in the market and a lot of research on that, in combination with standard chemotherapy which has shown a much better efficacy. The other things are some antibodies against, for example, CD30 in combination with chemotherapy in clinical trials which is very optimistic with much higher and better response rate compared to standard chemotherapy available at this point.
Melanie: When you talk about immunotherapy and people hear words like stem cell transplantation. What's involved in that? Is this controversial or no, not really? This is standard courses of treatment?
Dr. Ziari: Well, this is, first of all, a preliminary result that we see in combination with transplants that have some good results. I don't see that there might be an interaction with the stem cell transplant. What we have data about is about those patients that relapse either after transplant or they had relapse before transplant and they had so good response. We need to have a head to head comparison of clinical trials on those patients that have had those transplants versus non-transplant with immunotherapy to have a better answer.
Melanie: So, in the last few minutes, Dr. Ziari, give your best advice to the listeners on possible prevention or lifestyle behaviors where it relates to lymphoma and Hodgkin's lymphoma, and really something encouraging for them and why they should come to City of Hope for their lymphoma care.
Dr. Ziari: So, first of all, healthy lifestyle helps for most of the cancer, and the second, if you notice any abnormality and the symptoms, including swelling lymph node or drenching night sweats, loss of appetite, weight loss, please don't ignore them and see your doctor as soon as possible. City of Hope is the best place for this because we have the knowledge, we have the technology, and we have all the clinical trials and definitely multidisciplinary approach. So, in case you need to get the standard chemotherapy or clinical trial or, eventually, even if you need a stem cell transplant, we are one of the lead in the nation.
Melanie: Thank you so much. It's really great information. You're listening to City of Hope Radio and for more information you can go to cityofhope.org. That's cityofhope.org. This is Melanie Cole. Thanks so much for listening.
Understanding Hodgkin’s Lymphoma
Melanie Cole (Host): For people who are diagnosed with lymphoma, the Tony Stevenson lymphoma Center at City of Hope is one of the biggest and most successful treatment centers in the nation. Because of the vast experience in treating patients with lymphoma, the specialists there lead the field of hematopoietic cells transplantation with excellent outcomes. My guest today is Dr. Mo Ziari. He is Clinical Assistant Professor in the Department of Hematology and Hematopoietic Cell Transplantation and the Department of Medical Oncology and Therapeutics Research at City of Hope. Welcome to the show, Dr. Ziari. So, tell us a little bit about Hodgkin's lymphoma. We hear about non-Hodgkin’s. What is the difference between those two?
Dr. Mo Ziari (Guest): Good morning. The two main type of lymphoma are Hodgkin's lymphoma and non-Hodgkin's lymphoma, which are classified by certain unique characteristics of the cancer cell. So, for example, in Hodgkin's lymphoma you may see a reed sternberg cell, but in non-Hodgkin’s lymphoma which have a lot of different types, you may see different type of cell.
Melanie: And what would somebody notice? Lymphoma, being a blood disease, what would people notice as symptoms of something that would send them a red flag to go see a doctor?
Dr. Ziari: Well, people may see a swelling of the lymph node and drenching night sweat, weight loss--significant weight loss--and loss of appetite, sometimes itching and significant other symptoms. It depends if swelling lymph node is adjacent to an organ, it can cause organ damage as well.
Melanie: Are there certain risk factors? Is there a genetic component to Hodgkin's lymphoma?
Dr. Ziari: Well, there are some risks actually for this. One of them is a virus. We know Epstein-Barr virus has a significant role. The virus that cause infectious mono, and in lymphoma cells, they notice the presence of them in about 20% to 80%. The other risk factor is familial. So, we have seen this in same sex siblings and the identical twin of a person with Hodgkin's lymphoma are at high risk of developing the disease. Children with parents who have Hodgkin's are also at increased risk. The other thing is environment. So, fewer siblings, early birth order, single family home and fewer playmates are associated with increased risk of developing a Hodgkin's lymphoma, possibly due to lack of exposure to bacterial and viral infections at an early age.
Melanie: Wow! So people hear the word lymphoma--very scary, Dr. Ziari. If they had to choose, which is the preferable cancer? Hodgkin's or non-Hodgkin’s? Which one is more easily treatable?
Dr. Ziari: Well, now we have a lot of progress. Now, we have a lot of treatment for them but Hodgkin's lymphoma has a better prognosis with a very good success rate compared to non-Hodgkin's lymphoma. Again, it depends on the type of what type of non-Hodgkin's lymphoma--if it is aggressive or non-aggressive. But, in general, Hodgkin's lymphoma has a better prognosis.
Melanie: And what are some of the treatment options? What can you do for people that have been diagnosed?
Dr. Ziari: Well, a lot. As I mentioned, we a lot of good treatments available for Hodgkin's lymphoma. If they are at an earlier stage, they may require few chemotherapies plus/minus some radiation therapy. If they are more advanced and high risk, they may have to get more chemotherapy compared to earlier stage plus radiation therapy. There is some favorable risk and some non-favorable risk that we categorize based on this. Some blood work, for example if a patient is anemic, typically males, have a worse prognosis compared to females, aged more than 45, those patients with higher stages, meaning that more lymph nodes involvement and also bone marrow involvement, higher blood count also have a poor risk. And so, we stratify this based on a good risk, fair risk and poor risk. So, definitely poor risk has less response and good risk has a much better response.
Melanie: What are we looking at, at the horizon picture, Dr. Ziari, for lymphomas of all types? Because there are a few types of lymphoma and what are you seeing as going on in the future and the exciting new developments?
Dr. Ziari: Well, definitely there is a very, very good horizon for this such as immunotherapy. It's now in the market and a lot of research on that, in combination with standard chemotherapy which has shown a much better efficacy. The other things are some antibodies against, for example, CD30 in combination with chemotherapy in clinical trials which is very optimistic with much higher and better response rate compared to standard chemotherapy available at this point.
Melanie: When you talk about immunotherapy and people hear words like stem cell transplantation. What's involved in that? Is this controversial or no, not really? This is standard courses of treatment?
Dr. Ziari: Well, this is, first of all, a preliminary result that we see in combination with transplants that have some good results. I don't see that there might be an interaction with the stem cell transplant. What we have data about is about those patients that relapse either after transplant or they had relapse before transplant and they had so good response. We need to have a head to head comparison of clinical trials on those patients that have had those transplants versus non-transplant with immunotherapy to have a better answer.
Melanie: So, in the last few minutes, Dr. Ziari, give your best advice to the listeners on possible prevention or lifestyle behaviors where it relates to lymphoma and Hodgkin's lymphoma, and really something encouraging for them and why they should come to City of Hope for their lymphoma care.
Dr. Ziari: So, first of all, healthy lifestyle helps for most of the cancer, and the second, if you notice any abnormality and the symptoms, including swelling lymph node or drenching night sweats, loss of appetite, weight loss, please don't ignore them and see your doctor as soon as possible. City of Hope is the best place for this because we have the knowledge, we have the technology, and we have all the clinical trials and definitely multidisciplinary approach. So, in case you need to get the standard chemotherapy or clinical trial or, eventually, even if you need a stem cell transplant, we are one of the lead in the nation.
Melanie: Thank you so much. It's really great information. You're listening to City of Hope Radio and for more information you can go to cityofhope.org. That's cityofhope.org. This is Melanie Cole. Thanks so much for listening.