{"slug":"heme","tag":"heme","variants":["heme"],"description":"No description yet","count":34,"kinds":{"cancer":26,"term":8},"related":[{"slug":"lymphoma","tag":"lymphoma","shared":27},{"slug":"subtype-page","tag":"subtype-page","shared":19},{"slug":"umbrella","tag":"umbrella","shared":1}],"records":[{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/","tldr":"Acute myeloid leukaemia is an aggressive blood cancer where, after 40 years of the same chemotherapy, a wave of targeted drugs (FLT3, IDH, BCL-2, menin) arrived."},{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/","tldr":"Acute lymphoblastic leukaemia is the childhood cancer success story, and was the first disease treated with CAR-T and with a T-cell engager."},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/","tldr":"Diffuse large B-cell lymphoma (DLBCL) is an aggressive but curable lymphoma. CAR-T cures about 40% of relapsed patients, and off-the-shelf bispecifics are now approved."},{"id":"cll","kind":"cancer","name":"Chronic lymphocytic leukaemia","route":"/cancers/cll/","tldr":"A slow leukaemia that no longer needs chemotherapy: BTK inhibitors and venetoclax control it for years, often in fixed-duration courses."},{"id":"multiple-myeloma","kind":"cancer","name":"Multiple myeloma","route":"/cancers/multiple-myeloma/","tldr":"Multiple myeloma is a plasma-cell cancer with more new drug classes than any other: proteasome inhibitors, IMiDs, CD38 antibodies, BCMA CAR-T, bispecifics, and an ADC."},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/","tldr":"Hodgkin lymphoma is one of the most curable cancers, where the goal is now to cure with less toxicity, using brentuximab and, from 2026, first-line nivolumab."},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/","tldr":"Non-Hodgkin lymphoma is not one disease but a family of more than sixty cancers of the lymphocytes, the white blood cells of the immune system. About 95 per cent come from B cells and the rest from T or NK cells; some grow over years and are watched, others grow over weeks and are treated to cure. The family is the map; the subtype is the disease, and the subtype is what decides the treatment."},{"id":"lymphoma-classification-2022","kind":"term","name":"The two lymphoma classifications of 2022 (WHO-HAEM5 and ICC)","route":"/terms/lymphoma-classification-2022/","tldr":"Since 2022 there have been two reference classifications of lymphoma rather than one, published within months of each other by overlapping groups of experts. They agree about most diseases and disagree about a handful of names and boundaries, so the same biopsy can carry two different diagnoses depending on which book the pathologist used."},{"id":"lymphoma-b-versus-t-cell","kind":"term","name":"B-cell, T-cell and NK-cell lymphoma","route":"/terms/lymphoma-b-versus-t-cell/","tldr":"The first thing a lymphoma report says is which kind of lymphocyte the cancer came from. B cells make antibodies and carry a surface protein called CD20; T and NK cells kill infected cells directly and carry no CD20. That single difference is why B-cell lymphomas have had thirty years of new antibody treatments and T-cell lymphomas have not."},{"id":"lymphoma-indolent-versus-aggressive","kind":"term","name":"Indolent and aggressive lymphoma","route":"/terms/lymphoma-indolent-versus-aggressive/","tldr":"Lymphomas are split by how fast they grow, and the split decides what happens next. Aggressive lymphomas grow over weeks, are treated at once and are often cured. Indolent lymphomas grow over years, are often watched rather than treated, and are usually controlled for a long time rather than cured. The fast ones are the curable ones, which is the opposite of what most people expect."},{"id":"lymphoma-nodal-versus-extranodal","kind":"term","name":"Nodal and extranodal lymphoma","route":"/terms/lymphoma-nodal-versus-extranodal/","tldr":"A lymphoma that starts in a lymph node is called nodal; one that starts in an organ is called extranodal. A substantial minority of non-Hodgkin lymphomas start outside the lymph nodes, and where it started often changes the cause, the treatment and the outlook more than the cell type does."},{"id":"lymphoma-transformation","kind":"term","name":"Transformation of an indolent lymphoma","route":"/terms/lymphoma-transformation/","tldr":"A slow-growing lymphoma can change into a fast-growing one. It usually announces itself as one node growing much faster than the others, a sudden rise in lactate dehydrogenase, or new fevers and weight loss in somebody who has been stable for years. It is treated as the aggressive lymphoma it has become, not as the one it came from."},{"id":"lymphoma-pit-score","kind":"term","name":"Prognostic Index for T-cell lymphoma (PIT)","route":"/terms/lymphoma-pit-score/","tldr":"A four-item score that estimates the outlook in nodal T-cell lymphoma, built because the index used for B-cell lymphoma separated these patients poorly. It counts age over 60, a performance status of 2 or worse, a raised lactate dehydrogenase, and lymphoma in the bone marrow."},{"id":"lymphoma-htlv-1","kind":"term","name":"HTLV-1 (human T-lymphotropic virus type 1)","route":"/terms/lymphoma-htlv-1/","tldr":"A virus that infects T cells, is passed mainly through breastfeeding and sexual contact, and causes a lymphoma decades later in a small minority of the people it infects. It is common in south-western Japan, the Caribbean, west and central Africa, parts of South America, Romania and Iran, and uncommon elsewhere."},{"id":"lymphoma-lugano-gastrointestinal","kind":"term","name":"Staging a lymphoma of the stomach or bowel","route":"/terms/lymphoma-lugano-gastrointestinal/","tldr":"A lymphoma that starts in the stomach or bowel is staged by how deep it goes into the wall and how far along the lymph node chain it has travelled, not only by how many node regions are involved. The depth is measured by endoscopic ultrasound, and it decides whether antibiotics alone are worth trying."},{"id":"high-grade-b-cell-lymphoma-myc-bcl2","kind":"cancer","name":"High-grade B-cell lymphoma with MYC and BCL2 rearrangements (double-hit lymphoma)","route":"/cancers/high-grade-b-cell-lymphoma-myc-bcl2/","tldr":"An aggressive B-cell lymphoma defined not by how it looks but by two genetic faults in the same cell: a rearrangement of MYC, which drives growth, and one of BCL2, which blocks the cell from dying. It behaves worse than ordinary diffuse large B-cell lymphoma, so finding the rearrangements changes the treatment."},{"id":"mediastinal-grey-zone-lymphoma","kind":"cancer","name":"Mediastinal grey zone lymphoma","route":"/cancers/mediastinal-grey-zone-lymphoma/","tldr":"A lymphoma of the chest that sits between two diseases: it has some of the features of primary mediastinal B-cell lymphoma and some of classic Hodgkin lymphoma, and a pathologist cannot put it cleanly in either. It is recognised as an entity of its own, and the 2022 classifications restricted the name to lymphomas that involve the mediastinum."},{"id":"primary-effusion-lymphoma","kind":"cancer","name":"Primary effusion lymphoma","route":"/cancers/primary-effusion-lymphoma/","tldr":"A rare lymphoma that grows as fluid rather than as a lump: it fills the space around the lungs, the heart or the bowel without forming a mass. It is caused by Kaposi sarcoma herpesvirus and arises mostly in people with advanced HIV infection, and it is diagnosed by sending the fluid itself for testing."},{"id":"plasmablastic-lymphoma","kind":"cancer","name":"Plasmablastic lymphoma","route":"/cancers/plasmablastic-lymphoma/","tldr":"An aggressive lymphoma whose cells have taken on the appearance of plasma cells, so they no longer carry the CD20 marker that most B-cell lymphoma treatments aim at. It most often starts in the mouth or jaw, and about half of people diagnosed with it have HIV."},{"id":"t-cell-histiocyte-rich-large-b-cell-lymphoma","kind":"cancer","name":"T-cell/histiocyte-rich large B-cell lymphoma","route":"/cancers/t-cell-histiocyte-rich-large-b-cell-lymphoma/","tldr":"A lymphoma in which the cancer cells are a tiny minority of what the pathologist sees: scattered large B cells in a dense crowd of normal T cells and macrophages. It is a form of large B-cell lymphoma, it usually presents with disease in the liver, spleen or bone marrow, and it is easy to mistake for a different disease in both directions."},{"id":"ebv-positive-dlbcl","kind":"cancer","name":"EBV-positive diffuse large B-cell lymphoma","route":"/cancers/ebv-positive-dlbcl/","tldr":"A diffuse large B-cell lymphoma in which Epstein-Barr virus, the virus of glandular fever, is present in the tumour cells. It is diagnosed by a stain on the biopsy, it is commoner in east Asia and Latin America than in Europe, and it is treated in the same way as diffuse large B-cell lymphoma without the virus."},{"id":"primary-testicular-lymphoma","kind":"cancer","name":"Primary large B-cell lymphoma of the testis","route":"/cancers/primary-testicular-lymphoma/","tldr":"A large B-cell lymphoma that starts in a testicle rather than in a lymph node, usually in a man over 60, and shows itself as a painless swelling. It is the commonest cancer of the testicle in older men, and it behaves as one disease with lymphoma of the brain and of the eye, which is why treatment deliberately protects both."},{"id":"gastric-malt-lymphoma","kind":"cancer","name":"Gastric MALT lymphoma","route":"/cancers/gastric-malt-lymphoma/","tldr":"A slow-growing MALT lymphoma that grows in the lining of the stomach, usually caused by a long-standing infection with the bacterium Helicobacter pylori. It is the one lymphoma that is often cured by a fortnight of antibiotics, and a single chromosome change predicts the minority in whom antibiotics will not work."},{"id":"ocular-adnexal-malt-lymphoma","kind":"cancer","name":"Ocular adnexal MALT lymphoma","route":"/cancers/ocular-adnexal-malt-lymphoma/","tldr":"A slow-growing MALT lymphoma of the tissues around the eye: the conjunctiva, the eye socket, the tear gland or the eyelid. It usually shows itself as a painless salmon-pink patch on the white of the eye or as an eye that has begun to bulge, and it is controlled in almost everybody, often by a short course of radiotherapy."},{"id":"extranodal-nk-t-cell-lymphoma","kind":"cancer","name":"Extranodal NK/T-cell lymphoma","route":"/cancers/extranodal-nk-t-cell-lymphoma/","tldr":"An aggressive lymphoma of natural killer cells, always driven by Epstein-Barr virus, that destroys the tissues in the middle of the face: the nose, the palate and the sinuses. It is common in east Asia and Latin America and uncommon in Europe, and it is the one lymphoma in which ordinary anthracycline chemotherapy does not work at all."},{"id":"adult-t-cell-leukaemia-lymphoma","kind":"cancer","name":"Adult T-cell leukaemia/lymphoma","route":"/cancers/adult-t-cell-leukaemia-lymphoma/","tldr":"A T-cell lymphoma caused by a virus, HTLV-1, which is usually caught in infancy through breast milk and causes the lymphoma decades later in a small minority of the people it infects. It occurs in people from south-western Japan, the Caribbean, west and central Africa, parts of South America, Iran and Romania, and it comes in four forms that are treated very differently."},{"id":"alk-positive-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-positive anaplastic large cell lymphoma","route":"/cancers/alk-positive-anaplastic-large-cell-lymphoma/","tldr":"An aggressive T-cell lymphoma, mostly of children and young adults, whose cells carry a broken ALK gene and a protein called CD30 on the surface. Despite looking alarming down the microscope it is the T-cell lymphoma most often cured, and both of its markers are things that drugs can aim at."},{"id":"alk-negative-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-negative anaplastic large cell lymphoma","route":"/cancers/alk-negative-anaplastic-large-cell-lymphoma/","tldr":"An aggressive T-cell lymphoma that looks like its ALK-positive sibling under the microscope and carries the same CD30 marker, but lacks the broken ALK gene. It affects older people and is cured less often, and several genetic changes inside it predict very different outcomes."},{"id":"breast-implant-associated-alcl","kind":"cancer","name":"Breast implant-associated anaplastic large cell lymphoma","route":"/cancers/breast-implant-associated-alcl/","tldr":"A rare lymphoma that grows in the scar capsule the body forms around a breast implant, usually many years after the operation, and usually shows itself as sudden swelling of the breast from fluid around the implant. It is linked to textured implants, and when it is confined to the capsule it is usually cured by removing the implant and the capsule whole."},{"id":"primary-cutaneous-anaplastic-large-cell-lymphoma","kind":"cancer","name":"Primary cutaneous anaplastic large cell lymphoma","route":"/cancers/primary-cutaneous-anaplastic-large-cell-lymphoma/","tldr":"A cutaneous T-cell lymphoma that appears as one or a few red-purple nodules on the skin, often ulcerated, which may shrink on their own. Despite cells that look alarming under the microscope it stays in the skin in almost everybody and is treated with surgery or local radiotherapy rather than chemotherapy."},{"id":"lymphomatoid-papulosis","kind":"cancer","name":"Lymphomatoid papulosis","route":"/cancers/lymphomatoid-papulosis/","tldr":"A skin condition that keeps producing crops of small red bumps which ulcerate, crust and heal on their own over a few weeks, leaving small scars, and then come back. The biopsy looks like an aggressive lymphoma and the disease behaves nothing like one: nobody in the published series has died of it, but it carries a raised risk of a second lymphoma."},{"id":"mycosis-fungoides","kind":"cancer","name":"Mycosis fungoides","route":"/cancers/mycosis-fungoides/","tldr":"The commonest cutaneous T-cell lymphoma, and a disease that behaves like a long-term skin condition for most of the people who have it: flat scaly patches that have often been treated as eczema or psoriasis for years before anyone takes a biopsy. In its early stages life expectancy is close to normal, and the treatment is creams and light rather than chemotherapy."},{"id":"enteropathy-associated-t-cell-lymphoma","kind":"cancer","name":"Enteropathy-associated T-cell lymphoma","route":"/cancers/enteropathy-associated-t-cell-lymphoma/","tldr":"An aggressive T-cell lymphoma of the small bowel that arises out of coeliac disease, usually in somebody whose coeliac disease was diagnosed late or has not responded to a gluten-free diet. It often announces itself as a perforation or obstruction of the bowel in a person who is already underweight, which is why treatment has to deal with nutrition at the same time as the lymphoma."},{"id":"monomorphic-epitheliotropic-intestinal-t-cell-lymphoma","kind":"cancer","name":"Monomorphic epitheliotropic intestinal T-cell lymphoma","route":"/cancers/monomorphic-epitheliotropic-intestinal-t-cell-lymphoma/","tldr":"An aggressive T-cell lymphoma of the small bowel that looks and presents much like the lymphoma that complicates coeliac disease but has no connection with coeliac disease at all. It was separated out of that diagnosis in 2016, it is made of monotonous small to medium cells, and it often presents with perforation or obstruction of the bowel."}]}