lymphoma

An extra stretch of chromosome 9 that carries both of the molecules a tumour uses to switch off T cells, plus the enzyme that turns them up further. Nearly every classical Hodgkin lymphoma has it, which is why checkpoint drugs work so well there and so poorly in most other lymphomas.

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.

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.

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.

Led the IELSG trials that made MATRix induction and consolidation the standard for primary CNS lymphoma.

Veteran Italian medical oncologist who leads oncology and haematology at Humanitas and has co-authored major trials in lymphoma, liver cancer and novel targeted drugs.

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.

A change in the pocket of the survival protein BCL-2 where venetoclax has to fit. The protein still works and the drug no longer binds it. It can be detected in blood months before the disease starts growing again.

A swap of DNA that puts the survival gene BCL2 next to an antibody gene, so the cell makes far too much of a protein that stops it dying. It is the founding event of most follicular lymphomas and it happens in the bone marrow, often years before anything is wrong.

Basel haematologist-oncologist who co-led phase 2 trials of high-dose chemotherapy and autologous transplant in primary CNS lymphoma.

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.

A change in the enzyme BTK at the exact point where the drug grips it. The enzyme keeps working and the drug no longer holds, which is the usual reason a BTK inhibitor stops working after it has been working well.

Boston lymphoma doctor who led ZUMA-5, the trial that brought the CAR-T therapy axicabtagene ciloleucel to relapsed follicular lymphoma.

Led EPCORE NHL-1, the trial that established the subcutaneous bispecific epcoritamab for relapsed large B-cell lymphoma.

A change in the signalling tail of part of the B-cell receptor that leaves the receptor switched on without needing anything to bind it. It marks a group of large B-cell lymphomas that depend on that signal, and therefore on the enzyme BTK.

A stain showing that a lymphoma makes a lot of both the growth protein MYC and the survival protein BCL2, without the genes being rearranged. It predicts a worse course, but on its own it does not change the treatment.

A lymphoma that carries a rearrangement of MYC, the gene that drives growth, together with one of BCL2 or BCL6, the genes that stop a cell dying. Having both is far worse than having either, and it usually means a stronger treatment than standard R-CHOP.

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.

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.

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.

A change in an enzyme that puts a chemical silencing mark on DNA. The altered enzyme adds too much of the mark, which keeps a lymphoma cell locked in the state it should have grown out of. It is the one lymphoma mutation that currently selects a tablet.

Lille haematologist and President of LYSA, the French-Belgian lymphoma cooperative group, who led the RELEVANCE trial of chemotherapy-free therapy in follicular lymphoma.

Swiss oncologist who presides over the board of the international study group that runs clinical trials in lymphomas arising outside the lymph nodes.

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.

Led PRIMA, which established rituximab maintenance in follicular lymphoma, and co-chaired POLARIX in DLBCL.

Melbourne haematologist who led ALCANZA, the trial that showed brentuximab vedotin beats standard treatment for CD30-expressing cutaneous T-cell lymphoma.

Principal investigator of POLARIX, the trial that gave DLBCL its first improvement on R-CHOP in twenty years.

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.

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.

A test that asks whether a group of lymphocytes all descend from one cell. Cancer is one family; a normal immune response is a crowd. It is used when the appearance under the microscope does not settle the question.

A test that asks whether a group of lymphocytes is one family descended from a single cell, or a crowd of unrelated ones. Cancer is one family. It is used when the appearance under the microscope is not enough to decide.

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.

Medical oncologist who has led the Uganda Cancer Institute in Kampala, East Africa's principal cancer research and treatment centre.

Led the ZUMA-7 overall survival analysis that made CAR-T the standard second-line therapy for early-relapsing lymphoma.

New York lymphoma specialist who led AUGMENT, the trial that established lenalidomide plus rituximab as a chemotherapy-free option for relapsed follicular and marginal zone lymphoma.

Lymphoma specialist who wrote the definitive DLBCL review and helped establish polatuzumab and other new agents.

Lymphoma specialist and Chief Executive Officer of the National Cancer Centre Singapore, the country's largest public cancer centre.

The United Kingdom's only charity dedicated to lymphoma: a freephone helpline, support groups, a buddy scheme, a lymphoma trials database and a seat at the table when NICE and the Scottish Medicines Consortium appraise a lymphoma medicine.

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.

Chairs the European MCL Network and led TRIANGLE, which showed ibrutinib can replace transplant in younger mantle cell lymphoma patients.

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.

Led the pivotal glofitamab trial, establishing off-the-shelf bispecific antibodies for relapsed large B-cell lymphoma.

Led the ibrutinib and brexucabtagene autoleucel trials that transformed mantle cell lymphoma treatment.

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.

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.

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.

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.

Southampton lymphoma specialist who led the RATHL trial of PET-guided therapy in Hodgkin lymphoma and serves as NHS England's National Clinical Director for Cancer.

Boston lymphoma doctor who led KEYNOTE-170, the trial that showed pembrolizumab can control relapsed primary mediastinal B-cell lymphoma, and who helped bring PD-1 blockade to Hodgkin lymphoma.

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.

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.

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.

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.

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.

A single change in a small signalling protein, found in about two thirds of one kind of T-cell lymphoma. It is useful because it is specific to the tumour cells, while the other mutations in the same disease are also present in normal blood cells.

Haematologist-oncologist and Deputy Medical Director at University Hospital Düsseldorf, known for drug-response profiling in lymphoma and leukaemia.

Led ZUMA-1, the trial that made axicabtagene ciloleucel the first CAR-T therapy approved for lymphoma.

Helsinki oncologist who chairs the Nordic Lymphoma Group, the cooperative network that runs lymphoma trials and guidelines across the Nordic countries.

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.

Led JULIET, which brought tisagenlecleucel, the first CAR-T, to adults with relapsed large B-cell lymphoma.