Clinical pathway of Non-hodgkin lymphoma cancer

NHL (Non-Hodgkin Lymphoma) is a heterogeneous group of lymphoproliferative malignancies with variations in clinical behavior, prognosis, and treatment responses. The most common subtypes of NHL are diffuse large B-cell lymphoma and follicular lymphoma. According to the significant prevalence of this disease and the great variety through its pathogenesis, it’s essential to create and follow standardized clinical pathways to improve patient management and clinical outcomes. Here we aim to provide a comprehensive review of current clinical pathways for NHL in order to manage diagnosis, treatment, and long-term medical care. Methods: A thorough literature search of different databases such as PubMed, Scopus, and Web of Science was conducted focusing on studies about clinical decision-making processes, diagnostic strategies, and treatment protocols for NHL. Results: NHL clinical pathways are highly dependent on appropriate classification, diagnosis, and therapeutic techniques. Nowadays, several diagnostic tests are available for NHL; however, there are no commonly suggested screening tests for early diagnosis in at-risk patients. According to the latest international guidelines, surgical excisional biopsy is recognized as the gold standard for the diagnosis of lymphoma. The lymph node (or other tissue) excision biopsy allows micro-architecture analysis and provides enough material for immunocytochemistry, flow cytometry (if received unfixed), FISH investigations, and DNA and RNA extraction for molecular diagnostics. Non-Hodgkin lymphomas (NHL) may be associated with several factors, such as infections, chronic inflammation, immunodeficiency states, and environmental factors. The appropriate treatment strategy for NHL patients is determined considering the type, stage, histopathological features, and symptoms of their lymphoma. Chemotherapy, radiotherapy, immunotherapy, stem cell transplants, and surgery (in rare conditions) are currently the most common treatment strategies. The main therapy for early stages is radiotherapy, while stages III and IV are treated with chemoimmunotherapy and targeted therapy. Personalized medicine has also received a lot of attention lately for NHL patients. Conclusion: By providing a complete perspective on various diagnostic and treatment methods, it is possible to prioritize and select the most optimal approaches. In this way, the level of patient contentment is enhanced while reducing the financial and psychological burden on the government and the broader society context.

کلیدواژه ها:

NHL ، clinical pathways ، diagnosis ، treatment