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Glossary of Terms

The following excerpt is taken from Glossary of Non-Hodgkin's Lymphomas: Making Sense of Diagnosis, Treatment, and Options by Lorraine Johnston, copyright 1999 by O'Reilly & Associates, Inc. For book orders/information, call 1-800-998-9938. Permission is granted to print and distribute this excerpt for noncommercial use as long as the above source is included. The information in this article is meant to educate and should not be used as an alternative for professional medical care.

This glossary lists only terms specific to NHL. For a comprehensive glossary of cancer medical terminology, see Roberta Altman's The Cancer Dictionary. For more general medical terms, any one of several inexpensive medical dictionaries available in bookstores and libraries should suffice.

Guides to pronunciation are included.

But first, unusual phrases

There are a few specific words and phrases that may be jarring because they mean something other in medicine than they do in everyday usage:

When used in a medical context, it does not mean a funny story. It means a single case report not yet substantiated by studies using large numbers of people.

Impressive or not impressive
When used in a medical context, it does not mean anything derogatory. It means that, when the patient was examined, a particular feature did not strike the examiner as overwhelmingly unusual. For instance, after palpating your abdomen, the doctor may note in your medical record that your spleen was "not impressive." This means it did not feel enlarged, and that you did not report pain when she pressed on it.

Morbid or morbidity
In a medical context, they do not mean that you have a neurotic outlook. They simply mean illness, and are somewhat the opposite of mortality. You might read, for example, that a treatment resulted in 20 percent low-level morbidity, but only 2 percent mortality. Likewise, comorbidity means the illnesses a person has in addition to cancer, such as high blood pressure or diabetes.

The patient denies
This phrase does not mean that the doctor thinks you're lying. It's just used as the opposite of "the patient reports." For instance, your medical record might read, "The patient reports frequent morning cough, but denies the presence of phlegm."

A word often used by medical staff to describe the side effects of treatment. Your idea of what is tolerable may be much lower than their definition, because medicine defines a tolerable side effect as one that can be ameliorated with supportive care and that does not result in permanent organ damage. For you, these side effects may be intolerable.

NHL terminology

Absolute neutrophil count (NEW-tro-fil), also called ANC
The total number of neutrophils in the blood, a measure of one's ability to fight infection. Also called absolute granulocyte count or AGC.

Allogeneic transplant (al-lo-jeh-NAY-ic)
Marrow or stem cell transplant using donor stem cells of the same species that are immunologically different from the patient's.

Anemia (an-KNEE-me-uh)
A lack of adequate numbers of oxygen-carrying red blood cells.

Apheresis (AFF-er-EE-sis)
The channeling of blood out of the body and through specialized single-use tubing and equipment in order to extract various blood cell types, such as platelets or stem cells, from the bloodstream. After these cells are extracted, the blood is returned to the body. Also called hemapheresis, or leukapheresis for the extraction of white blood cells.

Apoptosis (app-uh-TOE-sis; variant: a-pup-TOE-sis)
Orderly cell death characterized by slow dissolving and reuse of cell parts by neighboring tissue. Some chemotherapy drugs induce apoptosis; others cause cell lysis or bursting.

Autologous transplant (aw-TAHL-uh-gus)
A marrow or stem cell transplant using the patient's own blood products.

B cells
White blood cells that have not traveled to the thymus (see T cells). B cells are responsible for many immune functions, such as producing proteins called antibodies that tag invaders for destruction.

Bone marrow
The soft, spongy matrix of all bones that produce blood cells. As we age, some marrow is replaced by fat cells or fibres.

Bulky disease
A cancer-specific phrase found often in the literature on lymphomas. Bulky disease is any cancerous lymph node or extranodal tissue that measures greater than ten centimeters in any dimension.

Centigrey or cGy
A measurement of radiation dose absorbed by the body.

Complete blood count or CBC
A count of the red, white, and platelet cells in peripheral blood.

Complete remission
The disappearance of all disease for longer than one month.

Consolidation therapy
Chemotherapy or radiotherapy intended to destroy all remaining cancer cells. Consolidation therapy frequently follows induction therapy.

Cytomegalovirus or CMV (sigh-toe-MEG-uh-low-virus)
One of a group of herpes viruses that can cause serious or fatal infection among the immune-suppressed.

-cytosis (sigh-TOE-sis)
A suffix denoting an abnormally high number of blood cells: Lymphocytosis, erythrocytosis, or thrombocytosis. See also -penia.

Cytotoxic (sigh-toe-TOX-ic)
A term for anything that kills cells. Many chemotherapy and radiotherapy regimens are cytotoxic to both healthy and cancerous cells.

Differentiation (diff-er-en-she-A-shun) The term used to describe cells maturing and developing for a particular task. For lymphomas, differentiation generally refers to white blood cells. In general, the less differentiated a cancer cell, the younger and more aggressive it is.

Erythrocyte (eh-REETH-ro-site)
A red blood cell. Red blood cells are responsible for carrying oxygen to body tissues.

Erythrocytosis (eh-REETH-ro-sigh-TOE-sis)
The condition of having abnormally high numbers of red blood cells.

Erythropenia (eh-REETH-ro-PEA-nee-uh)
The condition of having abnormally low numbers of red blood cells.

Event-free survival
The total amount of time that a patient survives, without relapse, following treatment. See Overall survival.

Graft-versus-host disease or GVHD
The phenomenon of donor marrow attacking the patient's body. GVHD can be mild, moderate, severe, or fatal.

Granulocytes (GRAN-you-lo-sites)
Types of white blood cells that attack bacteria by engulfing them. Eosinophils, neutrophils, basophils, and mast cells are types of granulocytes.

Hematocrit or Hct (he-MAH-to-crit)
Describes the percentage by volume of red blood cells in whole blood drawn for a CBC.

Hemaglobin (HE-muh-glow-bin)
The iron-containing protein found in the center of a red blood cell that can bind to and transport oxygen.

Human leukocyte antigens or HLAs
The proteins on the surfaces of white blood cells that characterize white blood cells from different individuals.

Induction therapy
Chemotherapy or radiotherapy intended to induce a remission.

The uncontrolled growth of white bloods cells in bone marrow, often overflowing to the circulating blood. As cancers of white blood cells, some leukemias and lymphomas are related; some are distinguished from each other only by their relative presence in marrow versus lymph nodes.

Leukocyte (LU-ko-site)
A general term for all white blood cells.

Leukopenia (LU-ko-PEA-nee-uh)
The condition of having abnormally low numbers of white blood cells. See also -penia.

Lymphocytes (LIM-foe-sites)
A subtype of white blood cells that have migrated to the lymph nodes or other lymphoid organs to await the signal to fight infection.

Lymphocytopenia (lim-foe-sit-o-PEA-ne-uh)
The condition of having abnormally low numbers of certain white blood cells called lymphocytes. See also -penia.

Lymphocytosis (lim-foe-sigh-TOE-sis)
The condition of having abnormally high numbers of certain white blood cells called lymphocytes. See also -cytosis.

The same as an average.

The midpoint. If eighty-one patients were treated with drug XYZ, and the time for white blood cell counts to recover following this treatment ranged from two to sixty days, after you rank the patients by the number of days required for their white blood cells to recover, the median is the number of days that it took patient number forty-one's white blood cells to recover.

Neutropenia (nu-trow-PEA-nee-uh)
The condition of having abnormally low numbers of one type of white blood cell called neutrophils.

Overall survival
The total amount of time that a patient survives following treatment, including relapses that were successfully retreated. See Event-free survival.

Partial response or partial remission
Describes a tumor's response to treatment that is 50 percent smaller or more, but still remains. It's not unusual to see a partial response on imaging halfway through treatment, and a total response by the end of treatment. See Complete response.

A suffix denoting abnormally low numbers of blood cells: leukopenia, erythropenia, or thrombocytopenia. See also -cytosis.

Peripheral blood (pe-RIFF-er-al)
Blood circulating in the body as opposed to bone marrow. Peripheral blood usually is withdrawn from an arm vein or central catheter.

Petechiae (pe-TEA-key-ah)
Small red or brown spots on the skin which are actually tiny hemorrhages. They may indicate abnormally low numbers of platelets or (thrombocytes).

A blood cell called a thrombocyte, important in the blood clotting process.

Prognosis (prog-KNOW-sis)
The expected or probable outcome.

The tumor-free time period, and is dated from the first, not the last, therapy session. Patients with tumors that recur within one month of treatment ending are considered to have had no remission. Disappearance of all disease is complete remission; reduction tumor size by more than 50 percent is considered partial remission.

Stable disease
One or more tumors still visible on imaging that are not growing. Stable disease for months or years is common among low-grade NHLs.

Stem cells
Young blood cells from which all blood cells develop.

T cells
Lymphocytes that have traveled to and resided in the thymus or are descended from those that have done so. T-cell function is immensely complex and is best described in immunology textbooks.

Thrombocyte (THROM-bow-site)
A blood cell commonly called a platelet.

Thrombocytosis (throm-bow-sigh-TOE-sis)
The condition of having abnormally high numbers of platelets.

Thrombocytopenia (throm-bi-sigh-toe-PEA-nee-uh)
The condition of having abnormally low numbers of platelets.

Total response or total remission
Describes a tumor's response to treatment. The tumor has either completely disappeared, or is so small and stable it may just be scar tissue. See also Partial response, Complete response, and Remission.

Tumor lysis syndrome
Arises from the death of certain large tumors and may arise shortly after chemotherapy is started. It is characterized by symptoms of kidney failure owing to excessive amounts of calcium, phosphate, and potassium being released by dying tumors. See "Metabolic Imbalances" in Chapter 9, Side Effects of Treatment.

Vancomycin-resistant enterobacteria or VRE
Intestinal bacteria that are no longer killed by one of the strongest antibiotics, Vancomycin.

Veno-occlusive disease
The closure of veins in the liver following high-dose therapy that may or my not accompany transplantation. See Chapter 9.

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