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Is it true that low grade lymphoma is not curable?

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Internal Medicine Specialist
Practicing since : 1980
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My mom is having indolent low grade lymphoma and just got diagnoised with DVT.She was on heparin and has been asked to come for 2 more sittings for next 6 mnths and she will be on anticoagulants all her it risky.the presence of low grade lymphoma and DVT.Is it true that low grade lymphoma is not curable.she will be having regular blood test and other stuff every 3 months as directed by doc.currenty no treament will be done.if anytime this spreads or if she develops any symptoms, therapy might be used.after remission, is relapse always a possibility? in case of relapse, can that be kept in control or survival is less after that.
Posted Tue, 18 Feb 2014 in Cancer
Answered by Dr. Rakesh Karanwal 12 days later
Brief Answer: Prognosis of low grade lymphoma is very good Detailed Answer: Hi XXXX, Thanks for your query. Firstly, you have not mentioned the type of Lymphoma (Hodgkin or Non-Hodgkin) and the Stage. I presume it must be Stage I (Earliest Stage). The effect of anticoagulants has nothing to do with prognosis of lymphoma. However, one has to care of the long-term side effects of anticoagulants are major bleeding, baldness, fever, nausea, vomiting, diarrhoea; skin rash; cholestatic liver damage. Regular (at least once a month) Prothrombin time/INR test is to be done and, INR is to maintained between 2-2.5, so as to prevent major bleeds, as well as its efficacy in preventing DVT. As long as your mom is on heparin, get her Blood calcium, Vitamin D levels and Bone Densitometry test done at regular intervals, as long-term heparin causes thinning of bones. Give her additional supplements of Calcium (1000mg) and Vitamin D3 (at least 0.5 micrograms of Calcitriol) Low grade lymphoma is curable with proper therapy. Chemotherapy with or without Radiotherapy; or, Antibody-mediated treatment would be initiated once the disease shows progression. There is NO relapse once the lymphoma is cured completely. In fact, 30-60% of indolent lymphomas get cured with treatment. However, relapse usually occurs when the treatment is stopped BEFORE complete cure. Lastly, the survival rate depends on the Stage and Type of lymphoma and the effect of treatment. Survival is normal in completely cured patients. Even otherwise, in complete remission, patients usually survive more than 20 years, as per the evidence available. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal
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Follow-up: Is it true that low grade lymphoma is not curable? 34 hours later
Thanks Doctor. She has low grade stage 1 MARGINAL NHL. She developed some blot clots in leg and is on aspirin.Earlier she was on Indomethacin. Now the hematologist says to stop indomethacin and continue aspirin. But the vascular surgeon says to have both together. Please advise what is correct. Her PET scan will be done, after which they will decide to do chemotherapy or radiotherapy.
Answered by Dr. Rakesh Karanwal 10 hours later
Brief Answer: Her treating doctors are the best judge Detailed Answer: Hi XXXX, Nice hearing back from you. Your mom's treating doctors- who are fully conversant with her clinical status- are the best judge regarding prescription of medicines. Differences in opinion are always there. The vascular surgeon might have some reasons to advocate use of both drugs. It would therefore be totally unethical on my part to doubt his clinical acumen. However, if I were her treating doctor, I would have preferred aspirin alone, along with anticoagulants. These would be sufficient to prevent recurrence of blood clot formation in any veins, PROVIDED the INR is maintained between 2-2.5 Take care, Col (Dr.) Rakesh Karanwal
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