In writing about my specific lymphoma situation, I think it’s important to know how exactly lymphoma works. So let’s talk briefly about some mechanics.
A few major components of our immune system are known as B-cells and T-cells. They attack invading viruses and bacteria in different ways. Those ways are real interesting, but out of the scope of this discussion. Moving on!
My lymphoma, technically my lymphomas, affect different types of these B-cells. Not just are B-cells different from T-cells, but B-cells are different than other B-cells based upon where in the immune system they’re sourced.
These, and most cells in our body, have a series of systems that regulate when they’re approved to duplicate themselves. For example, while a cell starts duplicating it’s genetic blueprint, it runs a check on its DNA to make sure there aren’t errors in it. If it’s clean, it proceeds to clone its DNA. Next it tests the clone to make sure it’s A-OK. If everything is fine, the cell starts to grown and then split in half (leaving one copy of the DNA in each cell).
These regulatory processes help our immune system cells duplicate just the right amount of themselves to keep the right sort of population count.
But what happens if the gene responsible for running that check gets damaged? A cell that has developed flaw in its DNA will be able to duplicate itself unchecked!
And that’s how things gets started. One cell gets DNA damage in just the right way that it stops recognizing that its damaged, and turns into 2 of them. Those 2 become 4 become 8 become 16. Ad infinitum. Or at least ad chemotherapum.
As I was saying earlier, B-cells are all different from one another. Even the B-cells that came from the same area will have slight differences from one another. Like tiny immunosnowflakes.
If you grab a whole handful of B-cells, or a whole lymph node full, and you find a bunch of B-cells that are exact duplicates of one another, something is wrong with the reproductive regulatory gene in that line. You’ve found lymphoma!
If you grab a lymph node full and find two different sets of B-cells that are exactly alike, then you want to dig deeper. Run some tests. Some flow cytometry. My hospital ran these tests, then ran more tests, then sent off the material to the UW research department to dig even deeper.
In my case, the two sets (or colonies) of B-cells were genetically different. Two lymphomas!
By studying what different signals these cells are sending out and receiving, what kinds of other things these cells are looking to bond with, hematopathologists can start to classify where in the immune system these B-cells originated. And with this, get some idea of how they’ll behave once they’re cancerous.
The current speculation is that I have one line of Follicular lymphoma, and one line of Marginal Zone lymphoma. Both of them aren’t particularly aggressive, but that also means that it might be tough to destroy them completely. The more aggressively cells reproduce, the easier it is to chemotherapy their heads off.