Non-Hodgkin's lymphoma is a type of cancer that begins in your lymphatic system, which is part of the body's germ-fighting immune system. In non-Hodgkin's lymphoma, white blood cells called lymphocytes grow abnormally and can form growths (tumors) throughout the body.

Non-Hodgkin's lymphoma is a general category of lymphoma. There are many subtypes that fall in this category. Diffuse large B-cell lymphoma and follicular lymphoma are among the most common subtypes. The other general category of lymphoma is Hodgkin's lymphoma.

SYMPTOMS

• Swollen lymph nodes in your neck, armpits or groin
• Abdominal pain or swelling
• Chest pain, coughing or trouble breathing
• Persistent fatigue
• Fever
• Night sweats
• Unexplained weight loss

B cells and T cells

Non-Hodgkin's lymphoma most often begins in the:

• B cells - B cells are a type of lymphocyte that fights infection by producing antibodies to neutralize foreign invaders. Most non-Hodgkin's lymphoma arises from B cells. Subtypes of non-Hodgkin's lymphoma that involve B cells include diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma and Burkitt lymphoma.
• T cells - T cells are a type of lymphocyte that's involved in killing foreign invaders directly. Non-Hodgkin's lymphoma occurs much less often in T cells. Subtypes of non-Hodgkin's lymphoma that involve T cells include peripheral T-cell lymphoma and cutaneous T-cell lymphoma.

Non-Hodgkin's lymphoma generally involves the presence of cancerous lymphocytes in your lymph nodes. But the disease can also spread to other parts of your lymphatic system. These include the lymphatic vessels, tonsils, adenoids, spleen, thymus and bone marrow. Occasionally, non-Hodgkin's lymphoma involves organs outside of your lymphatic system.

CAR T-cells for B cell lymphoma 

(Non-Hodgkin's lymphoma) 

There are two main types of lymphoma:

• Hodgkin's lymphoma

• Non-Hodgkin's Lymphoma (NHL)

Hodgkin's lymphoma is treatable, especially in its early stages. Hodgkin's lymphoma is a B-cell Lymphoma that arises from a Reed-Sternberg cell (named after the doctors who first discovered this cell). Hodgkin's lymphoma is caused by a gene mutation in the growing white blood cells called B lymphocytes. These mutations are not inherited. Hodgkin's lymphoma begins in the lymph nodes of the neck or chest and then spreads from one part of the lymphatic system to another. In Hodgkin's lymphoma, the tumors usually contain unique cells called Reed-Sternberg cells.

Non-Hodgkin's lymphoma (also called Non-Hodgkin's Lymphoma) is a disease in which cancer cells form in the lymphatic system and start to grow uncontrollably.

There are several different types of lymphomas. Some involve lymphoid cells (called Reed-Sternberg cells) and are grouped under the heading of Hodgkin's lymphoma. All other forms of lymphoma fall into the non-Hodgkin's grouping. The different forms of non-Hodgkin's lymphoma are marked by the malignant growth of white blood cells that live in the lymph nodes, called lymphocytes.

Aggressive NHL (Non-Hodgkin's Lymphoma) progresses quickly. According to the Leukemia and Lymphoma Society (LLS), about 60 percent of people with NHL have aggressive subtypes of the disease. Diffuse large B-cell Lymphoma (DLBCL) is the most common aggressive subtype. For stage IV NHL, the 5-year survival rate is around 63% which is much less than Hodgkin's lymphoma. 

Cellular immunotherapy with CAR T-cell has changed the treatment landscape of B-cell Non-Hodgkin's Lymphoma (NHL), especially for aggressive B-cell Lymphomas. Single-center and multicenter clinical trials with CAR T-cell therapy have shown great activity and long-term remissions large B-cell Lymphoma (DLBCL- Diffuse large B-cell Lymphoma, or DLBCL, is a cancer that starts in white blood cells called lymphocytes) when no other effective treatment options are available.

CAR T-cells for B-cell Lymphoma (Non-Hodgkin's lymphoma)

• 39 B-cell Lymphoma patients have been treated by CAR-T

• 3-month best overall response rate is 79.5% (31/39);

• The first patient treated with this product achieved complete remission in the first 3 months and had a 24-month relapse free until today. 

Side Effects of CAR T-cells 

The side effects of CAR T-cells vary with the type of treatment the patient uses. There are several large companies and a few smaller companies with differing technology. The newer technologies have fewer side effects that the so-called first generation of CAR T-cells.

The most prominent side effect of CAR T-cell treatment is Cytokine-Release Syndrome (CRS). This potentially serious side effect is frequently associated with CAR T-cell therapy. Cytokines (chemical messengers that help the T cells carry out their functions) are produced when the CAR T-cells multiple in the body and kill the cancer cells. CRS symptoms can range from mild flulike symptoms that include.

• Nausea

• Fatigue

• Headache

• Chills

• Fever