First, let's clear up some very important differences between sold cancers (for example, bone marrow cancer) and blood cancers (lymphoma with bone marrow involvement). Marginal zone lymphoma (MZL) is a slow-growing blood cancer, specifically, as miscortes says, of one of your types of white blood cells, the B cells. B cells produce antibodies to fight germs. B Cells are borne and grow in the bone marrow. When they mature, they circulate in your blood stream and lymph system, which includes certain lymphatic organs such as the spleen.
Although lymphoma can advance to infiltrate the bone marrow, it is not at all the same as bone marrow cancer. MZL is a cancer of your B-cells. Bone marrow cancer is a cancer of bone cells and it's a solid cancer. Unlike some solid cancers (i.e., breast, lung, colon, bone and marrow, etc.), even advanced lymphomas can often be reversed. There is much reason to hope that you can live a long and good quality life with long periods (years and sometimes decades) of remission alternating with treatments. In an indolent (slow growing) lymphoma, treatment isn't generally needed unless a patient is symptomatic.
I am assuming remission is what you mean by "my blood work looks very good" and that you are currently in remission, or at least stable disease that is not progressing or increasing. Presumably, you also get periodically scanned (CT or PET) or to look for any possible recurrence or progression. If you are in remission, the disease isn't increasing. It's not detectable at all.
A solid cancer starts in one spot and may spread through the blood or lymph system to set up shop in another organ. That is called metastasis. In a sold cancer, the cancerous cells take over. They crowd out and starve healthy organ tissue and the organ eventually fails. If cells from a solid cancer are found in lymph nodes, that is usually not great news and we worry about it spreading to possibly destroy other organs. But in marginal zone lymphoma (mzl), the cancerous B cells are lymph cells. So, of course, lymphoma cells will be found in lymph nodes. That's how they roll. ;) Presence in lymph nodes per se is not bad news for a lymphatic cancer.
You don't say, but it sounds as if you have splenic marginal zone lymphoma, SMZL. In SMZL, finding lymphoma cells in bone marrow is not uncommon. But that was not the case for you apparently? (I can't actually tell from your question.) Did you have a bone marrow biopsy? That is how bone marrow involvement is detected and measured. If there was bone marrow involvement, the lymphoma can still be eradicated through chemotherapy and your bone marrow will regenerate and be normal again.
Splenectomy, such as you had, can result in remissions for SMZL. Other treatments (chemo, radiation, immunotherapies) are similar to other indolent lymphomas - not typically initiated until the patient is symptomatic.
In studies, rituximab (trade name, Rituxan), an immunotherapy, given with or without chemotherapy was found to have major activity in patients with SMZL. Rituximab is often the treatment of choice, especially in older patients with SMZL. It is not chemotherapy so usually has few side effects. For more on Rituximab/Rituxan: http://www.lymphomation.org/rituxan.htm
If you'd like to know more or have more questions, Patients Against Lymphoma's lymphomation is available on the web and on Facebook. We have a large group of survivors and supporters on FB and we invite you to join us to get knowledge and support from other patients and our patient navigators. We'd also suggest that you register for the webmagic discussion forum and NHL cyberfamily, these are two large lymphoma patient groups. There you will find other marginal zone survivors to share experiences with and be encouraged by.
PAL on facebook: http://www.facebook.com/lymphomation
NHL discussion forum: http://forums.lymphoma.com/
NHLcyberfamily: http://www.nhlcyberfamily.org/
More on Splenic Marginal Zone Lymphoma (SMZL): http://www.lymphomation.org/type-mz.htm#spleenic
Comment Reply
Hi Wisemar,
I am so sorry you are going through this worry.
First, let's clear up some very important differences between sold cancers (for example, bone marrow cancer) and blood cancers (lymphoma with bone marrow involvement). Marginal zone lymphoma (MZL) is a slow-growing blood cancer, specifically, as miscortes says, of one of your types of white blood cells, the B cells. B cells produce antibodies to fight germs. B Cells are borne and grow in the bone marrow. When they mature, they circulate in your blood stream and lymph system, which includes certain lymphatic organs such as the spleen.
Although lymphoma can advance to infiltrate the bone marrow, it is not at all the same as bone marrow cancer. MZL is a cancer of your B-cells. Bone marrow cancer is a cancer of bone cells and it's a solid cancer. Unlike some solid cancers (i.e., breast, lung, colon, bone and marrow, etc.), even advanced lymphomas can often be reversed. There is much reason to hope that you can live a long and good quality life with long periods (years and sometimes decades) of remission alternating with treatments. In an indolent (slow growing) lymphoma, treatment isn't generally needed unless a patient is symptomatic.
I am assuming remission is what you mean by "my blood work looks very good" and that you are currently in remission, or at least stable disease that is not progressing or increasing. Presumably, you also get periodically scanned (CT or PET) or to look for any possible recurrence or progression. If you are in remission, the disease isn't increasing. It's not detectable at all.
A solid cancer starts in one spot and may spread through the blood or lymph system to set up shop in another organ. That is called metastasis. In a sold cancer, the cancerous cells take over. They crowd out and starve healthy organ tissue and the organ eventually fails. If cells from a solid cancer are found in lymph nodes, that is usually not great news and we worry about it spreading to possibly destroy other organs. But in marginal zone lymphoma (mzl), the cancerous B cells are lymph cells. So, of course, lymphoma cells will be found in lymph nodes. That's how they roll. ;) Presence in lymph nodes per se is not bad news for a lymphatic cancer.
You don't say, but it sounds as if you have splenic marginal zone lymphoma, SMZL. In SMZL, finding lymphoma cells in bone marrow is not uncommon. But that was not the case for you apparently? (I can't actually tell from your question.) Did you have a bone marrow biopsy? That is how bone marrow involvement is detected and measured. If there was bone marrow involvement, the lymphoma can still be eradicated through chemotherapy and your bone marrow will regenerate and be normal again.
Splenectomy, such as you had, can result in remissions for SMZL. Other treatments (chemo, radiation, immunotherapies) are similar to other indolent lymphomas - not typically initiated until the patient is symptomatic.
In studies, rituximab (trade name, Rituxan), an immunotherapy, given with or without chemotherapy was found to have major activity in patients with SMZL. Rituximab is often the treatment of choice, especially in older patients with SMZL. It is not chemotherapy so usually has few side effects. For more on Rituximab/Rituxan: http://www.lymphomation.org/rituxan.htm
If you'd like to know more or have more questions, Patients Against Lymphoma's lymphomation is available on the web and on Facebook. We have a large group of survivors and supporters on FB and we invite you to join us to get knowledge and support from other patients and our patient navigators. We'd also suggest that you register for the webmagic discussion forum and NHL cyberfamily, these are two large lymphoma patient groups. There you will find other marginal zone survivors to share experiences with and be encouraged by.
PAL on facebook: http://www.facebook.com/lymphomation
NHL discussion forum: http://forums.lymphoma.com/
NHLcyberfamily: http://www.nhlcyberfamily.org/
More on Splenic Marginal Zone Lymphoma (SMZL): http://www.lymphomation.org/type-mz.htm#spleenic
big, healthy healing hugs,
Liz for Patients Against Lymphoma (PAL)
August 16, 2010 - 5:20pmThis Comment
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