Discord Lymphoma Overview

When a person has discordant bone marrow involvement or “discordant lymphoma” two different types Lymphomas are found in two different places in the same person, such as lymph nodes, bone marrow, liver, or spleen.

An example of non-Hodgkin’s lymphoma or NHL discordance is finding an aggressive lymphoma on a lymph node biopsy but a slow-growing (indolent) lymphoma on a bone marrow biopsy, called bone marrow involvement (BMI).

Consistent and inconsistent effects (if any) of BMI in lymphoma appear to depend on Types of Lymphoma found and some additional context About the course of the disease. In general, drawing firm conclusions about prognosis based on consistent or inconsistent bone marrow involvement is challenging because, in many cases, physicians rely on limited published data.

Bone marrow involvement

Most indolent or slow-growing B-cell lymphomas, such as mantle cell lymphoma (MCL), follicular lymphoma (FL), and marginal zone lymphoma, have a BMI at diagnosis. However, for diffuse large B-cell lymphoma (DLBCL), an aggressive type of non-Hodgkin lymphoma, most studies report that approximately 10% to 15% of cases have BMI at diagnosis. However, testing the bone marrow is important to determine if the lymphoma has spread and to develop an appropriate treatment plan.

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Harmony and Discord

When BMI occurs in non-Hodgkin lymphoma, it is usually cancer cells in the bone marrow similar Cancer cells found in other sites, such as in the lymph nodes, are called coherence.

Less commonly, discordance refers to those cases of lymphoma whose histology or the features and appearance of cancer cells, different Important pathway between the bone marrow and other involved sites. In fact, one type will be more aggressive, while the other will grow slowly.

Discordant is different from the compound type, which refers to two or more lymphoma cells in different areas. identical Lymph node samples.

Discordance is also distinct from transformation, which is when a lymphoma starts out slowly or indolently, but then transforms into an aggressive lymphoma (usually DLBCL) over the course of the disease. Richter’s transformation is an example of chronic lymphocytic leukemia that transforms into DLBCL or Hodgkin’s lymphoma.

Diagnosis, Treatment and Outcomes

Unfortunately, there is not a lot of consensus on how often dissonant lymphomas are diagnosed, their clinical presentation, or how best to treat them. Data are primarily derived from individual cases reported in the scientific literature and reviews of small studies that attempt to identify patterns and associations.

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In indolent lymphoma, consistent BMI has historically been associated with poorer survival outcomes, estimated to occur in 40% to 70% of patients with follicular lymphoma (FL). This finding led to an escalation of the Ann Arbor stage of IV and thus a higher International Prognostic Index score, implying a worse survival prognosis for these cases.

Discordant bone marrow involvement appears to be relatively uncommon in slow-growing lymphomas such as follicular and marginal zone lymphomas.

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According to a 2016 study, more and larger studies are needed to better judge what concordance and discordance mean for people with lymphoma.

  • Consistent bone marrow involvement in DLBCL appears to indicate worse outcomes and worse overall survival than cases without bone marrow involvement.
  • Discordant bone marrow involvement with indolent or slow-growing B-cell lymphoma in newly diagnosed DLBCL no appears to have a negative impact on prognosis.

Moreover, while FDG-PET scanning is a useful tool for diagnosing consistent bone marrow involvement in DLBCL, it may be much more sensitive in detecting discordant bone marrow involvement.

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Frequently Asked Questions

  • What is discordant lymphoma?

    Discord lymphoma is used to describe people who have two different types of lymphoma in two different areas of their body. In many discordant cases of lymphoma, this occurs in the bone marrow and lymph nodes, but other potential sites may include the spleen and liver.

  • What is follicular lymphoma?

    Follicular lymphoma is a common type of non-Hodgkin lymphoma. It grows slowly but is difficult to detect until the disease has spread to multiple areas of the body, often including multiple lymph nodes, bone marrow, etc. When follicular lymphoma is diagnosed early, it can often be cured with radiation therapy.

  • Are marginal zone lymphomas common?

    No, it’s not considered common. Lymph node marginal zone B-cell lymphoma is a type of non-Hodgkin lymphoma that is usually identified by enlarged lymph nodes in the neck, armpit, or groin. Similar to follicular lymphoma, radiation therapy can effectively control the disease if diagnosed early.

    understand more:

    Overview of lymph node marginal zone B-cell lymphoma