Bionic Jen

Extranodal NK or T Cell Lymphoma – Nasal

Abstracts from below websites.

http://www.lymphomainfo.net/nhl/types/nk-t-nasal.html

http://www.emedicine.com/ent/byname/nk-cell-lymphomas-of-the-head-and-neck.htm 

The extranodal nasal NK or T Cell lymphomas are rare forms of lymphoma. Nasal-type T/NK-cell lymphomas are common in  Asia and in parts of Latin America but rare in the United States and in Europe. This may reflect an ethnic predisposition for the disease. Children may be effected as well as adults. Most studies have shown a male-to-female ratio of 2:1 to 3:1  

The natural killer (NK) cell is a cytolytic cell that is an important component of the body’s immune system. These cells are capable of conducting immune surveillance for tumorous, bacterial, and viral invaders. NK-cell lymphoma is a type of non-Hodgkin lymphoma (NHL).

NK or T cell nasal lymphomas represent about 75% of all nasal lymphomas, the rest being B-cell lymphoma. Tumors are most common in the nasal cavity but other sites may include the skin, gastrointestinal tract, testis, kidney, upper respiratory tract and rarely the eye/orbit. The most common presenting symptoms are nasal obstruction, nasal discharge, nasal  mass with bleeding and local bony destruction. Rarely they may present with skin ulcer or GI perforation if these sites are primarily involved. About 10-20% of patients presenting with nasal NK/T-cell lymphoma may also have skin involvement at same  time. A high index of suspicion is required for the diagnosis of this disease. Because of the small size of the specimen and the necrotic nature of the tumor, biopsy of the nasal tissue may not be easy to interpret. Repeated biopsies are often required.

The course of the disease is usually aggressive, with a large number of Asian studies reporting a median survival of 6 to 25 months. Several American and European studies have shown similar results. The cause, like in many lymphomas, is unclear but it appears to  be related to the Epstein-Barr virus (EBV). 

NK-/T-cell lymphoma has a higher local relapse rate (21.4%) than that of T-cell lymphomas presenting in the nasopharynx (5%) or B-cell lymphomas presenting in the nasopharynx (0%). Fewer recurrences in the cervical nodes are reported (2.4%) than those reported for T-cell (10%) and B-cell (14.3%) malignancies.

Treatment:

My treatment involves chemotherapy (ICE) and radiotherapy (IMRT) which will last a total of 4 to 5 months.

Below is my treatment plan and the doctors will monitor my progress and adjust the treatment accordingly.

I started my 1^st Chemotherapy on 13^th Oct 2008.

Wk42~43    1st Chemotherapy (Admitted to hospital for 4 days on Wk42)

Wk44~49    Radiotherapy (30mins every Mon to Fri)

Wk50~52    2nd Chemotherapy (Admitted to hospital for 4 days on Wk50)

Wk1~3        3rd Chemotherapy (Admitted to hospital for 4 days on Wk1)

Wk4~6        4th Chemotherapy (Admitted to hospital for 4 days on Wk4)

Wk7~9        5th Chemotherapy (Admitted to hospital for 4 days on Wk7)

http://www.cancerbackup.org.uk/Treatments/Chemotherapy/Combinationregimen/ICER-ICE

http://www.nccs.com.sg/pat/05_04.htm