Tumours of the Immune System


Tumours of the immune system are malignant proliferations of haematopoietic cells, and are classified according to their cell of origin. Disorders of the myeloid lineage result in acute or chronic myeloid malignancy, whereas disorders of the lymphoid lineage result in Hodgkin lymphoma, non‐Hodgkin lymphoma (NHL) and multiple myeloma. These malignancies share many similarities in that acquired genetic changes are involved in their aetiology and are useful prognostic markers. The diagnosis of these conditions involves microscopic examination of peripheral blood or tumour biopsy and often, bone marrow examination. This is also supplemented by immunophenotyping and cytogenetic and molecular analysis. Treatment has previously been based on nonspecific cytotoxic agents and external beam irradiation but increasingly, targeted therapies such as the tyrosine kinase inhibitor, imatinib, and monoclonal antibodies are included in frontline therapy.

Key Concepts:

  • Tumours of the immune system are classified based on morphologic, cytochemical, immunophenotypic, and genetic features.

  • These malignancies exhibit a range of behaviour, with some developing extremely slowly over years, requiring minimal or no therapy, whereas others are among the most aggressive malignancies known and require treatment as emergencies.

  • Most types present most often in the elderly, but they occur throughout life and some are among the commonest childhood malignancies.

  • Cytogenetic and molecular abnormalities are invaluable in guiding the diagnosis and management route of some haematological malignancies.

  • General treatment options comprise radiotherapy, chemotherapy and targeted therapies, depending on the specific disease.

  • A proportion of these malignancies are curable with appropriate treatment, whereas others are susceptible to long term control which falls short of complete eradication, and may require multiple episodes of treatment.

  • This is a field in which research into mechanisms of pathogenesis and therapy is having a direct impact upon treatments and cures.

Keywords: leukaemia; lymphoma; myeloma; chemotherapy; immunotherapy; stem cell transplantation


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Further Reading

Hoffbrand AV (2010) Postgraduate Haematology. Chichester: Wiley‐Blackwell.

Swerdlow SH, Campo E, Harris NL et al. (2008) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon: International Agency for Research on Cancer.

Web Links

Cancer Research UK http://cancerhelp.cancerresearchuk.org/type/lymphoma/

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Johnson, Peter WM, and Lim, Sean H(May 2012) Tumours of the Immune System. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0001248.pub2]