malignant lymphoma



Overview

Definition

Malignant lymphoma is a general term for a group of malignant tumors that originate in the lymphohematopoietic system.

Strictly speaking, all lymphomas are malignant tumors in their own right, so malignant lymphoma is simply an emphasis on the nature of the lymphoma disease.

Lymphoma can occur in any part of the body, lymph nodes, tonsils, spleen and bone marrow are most likely to be involved.

Types

According to histopathologic changes, lymphomas can be divided into two major groups: Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL).

Hodgkin’s lymphoma

Also known as Hodgkin’s disease, it originates mainly in the lymph nodes and is characterized by progressive enlargement of the lymph nodes.

The 2016 WHO classification of tumors of the lymphohematopoietic system is currently used, which is divided into two categories: nodular lymphocyte-predominant Hodgkin’s lymphoma and classic Hodgkin’s lymphoma.

Nodular lymphocyte-dominant type accounts for 5% of Hodgkin’s lymphomas and classic type accounts for 95% of Hodgkin’s lymphomas.

Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)

More than 95% are nodular, with microscopic hyperplasia of a single small lymphocyte with scattered large tumor cells (popcorn-like).

Classical Hodgkin’s lymphoma (CHL)

In China, mixed cell type (MCHL) is the most common type of classical HL, followed by nodular sclerosing type (NSHL), lymphocyte-rich type (LRHL), and lymphocyte-depleted type (LDHL).

Non-Hodgkin’s lymphoma

It is a group of lymphomas with different histologic features and sites of onset that are prone to early distant spread.

Depending on the cellular origin, they can be classified as B-lymphocyte, T-lymphocyte, or natural killer (NK) cell lymphomas.

Based on biological characteristics, they can be further classified as inert lymphomas, aggressive lymphomas, and highly aggressive lymphomas.

The main common non-Hodgkin’s lymphoma subtypes are:

Diffuse large B-cell lymphoma (DLBCL)

It is the most common type of NHL and is an aggressive lymphoma, accounting for 35% to 40% of cases. Most are primary DLBCL, but can also progress or transform from inert lymphoma.

Typing: the 2016 edition of WHO typing further divides DLBCL into germinal center origin and non-germinal center origin based on cellular origin.

Marginal zone lymphoma (MZL)

Marginal zone refers to the structure between the lymphoid follicle and the follicular coat; lymphomas occurring in this area are of B-cell origin and are inert lymphomas. They can be divided into 3 subtypes according to the site of involvement:

Extraconjunctival mucosa-associated lymphoid tissue marginal zone lymphoma (MALT).

Splenic B-cell marginal zone lymphoma.

Lymphoma of the marginal zone of lymph nodes.

Follicular lymphoma (FL)

It is a germinal center lymphoma, of B-cell origin, which is an inert lymphoma, often with CD10⁺, Bcl6⁺, and Bcl2⁺, with t(14;18).

Most often elderly onset, often with splenic and bone marrow involvement, good response to chemotherapy but not curative, long course, recurrent relapses or conversion to aggressive.

Mantle cell lymphoma (MCL)

It is clinically common in elderly men and belongs to aggressive lymphoma, accounting for 6%～8% of non-Hodgkin’s lymphoma.

This type develops rapidly, with a median survival of 2 to 3 years and a low rate of complete remission with chemotherapy.

Burkitt’s lymphoma/leukemia (BL)

t(8;14) with MYC gene rearrangement is diagnostic, proliferates extremely rapidly, and is a severe aggressive non-Hodgkin’s lymphoma.

Angioimmunoblastic T-cell lymphoma (AITL)

It is an aggressive T-cell lymphoma that accounts for 2% of non-Hodgkin’s lymphomas.

It is prevalent in the elderly and presents clinically with fever, enlarged lymph nodes, and a positive Coombs test with multiple strains of hyperimmunoglobulinemia.

Anaplastic large cell lymphoma (ALCL)

It is an aggressive lymphoma, accounting for 2% to 7% of non-Hodgkin’s lymphoma.

It occurs in children. Tumor cells vary in shape and size and may resemble R-S cells, which can sometimes be confused with Hodgkin’s lymphoma.

Peripheral T-cell lymphoma (non-specific) (PTCL)

It is a heterogeneous group of malignant tumors originating from mature (post-thymic) T cells and NK cells, which are aggressive and have a poor prognosis.

In China, PTCL accounts for 25%-30% of non-Hodgkin’s lymphoma cases, which is significantly higher than the 10%-15% in Europe and the United States.

Mycosis fungoides/Sezary syndrome (MF/SS)

It is an inert lymphoma, which is commonly characterized by myxoid granulomas, and is known as Sezary syndrome if it affects the terminal bloodstream.

Incidence

The age of lymphoma incidence in China is mostly between 30 and 40 years old, with a unimodal distribution.

Data from the World Health Organization GLOBOCAN 2020 shows the following incidence of lymphoma in China:

Hodgkin’s lymphoma

In 2020, there were 6829 new cases of Hodgkin’s lymphoma HL) in China, of which 4506 were male and 2323 were female; and there were 2807 deaths, of which 1865 were male and 942 were female.

Non-Hodgkin’s lymphoma

In 2020, there were 92,834 new cases of non-Hodgkin’s lymphoma (NHL) in China, including 50,125 cases in men and 42,709 cases in women; 54,351 deaths, including 29,721 cases in men and 24,630 cases in women.

The incidence rate and mortality rate of NHL in males ranked 10th among all malignant tumors; the incidence rate and mortality rate of NHL in females did not enter the top 10 of all malignant tumors.

Causes

Causes

The exact cause of malignant lymphoma is not clear, but it is believed to be related to viral and bacterial infections, defective or suppressed immune function, and heredity.

Viral and bacterial infections

The detection rate of EBV in malignant lymphomas such as NK/T-cell lymphoma, Hodgkin’s lymphoma, and Burkitt’s lymphoma is up to 70% or more, and there are also cases such as gastrointestinal mucosa-associated lymphoid tissue lymphomas which may be associated with Helicobacter pylori infection, so viral-bacterial infections may be related to the development of malignant lymphomas.

Deficiency or suppression of immune function

Malignant lymphoma is a disease originating from the immune system, and immune function deficiency is one of the important reasons for its development. In addition, long-term use of immunosuppressants such as methotrexate and azathioprine will also increase the risk of malignant lymphoma.

Heredity

Research shows that malignant lymphoma can show family aggregation, such as small lymphocytic lymphoma relatives will increase the risk of lymphoma by about 5 times.

Predisposing Factors

The following factors may increase the risk of malignant lymphoma.

Work environment and occupation

Working environment with long-term exposure to chemical agents such as pesticides, herbicides, paints, etc., and people exposed to radioactive substances such as hospital radiology staff and nuclear power plant workers.

Age

The two peaks of malignant lymphoma incidence are 15-30 years old and over 55 years old, especially middle-aged and elderly men, the risk of malignant lymphoma will increase year by year.

Pathogenesis

The exact pathogenesis of lymphoma is not well understood and may be related to the following mechanisms:

EBV can encode the production of the tumorigenic latent membrane protein LMP1, which inhibits DNA damage repair in normal cells, resulting in the development of cancer.

Innate immune deficiency, infection with other immunodeficiency viruses or long-term use of immunosuppressive drugs can cause immune cell dysfunction and pathological proliferation to form cancer cells.

Genetic abnormalities such as chromosome deletions, translocations and gene mutations may activate oncogenes or inactivate oncogenes, causing abnormal proliferation and differentiation of lymphocytes.

Symptoms

Lymphocytes can undergo malignant transformation in their “birthplace” (thymus, bone marrow) as well as in lymph nodes, spleen, tonsils and lymphoid tissues of other tissues and organs throughout the body.

Advanced malignant lymphoma can also invade parts other than lymphatic tissues, and the clinical manifestations of lymphoma are complicated and diversified.

This entry only briefly describes the main symptoms, for more symptoms, please refer to reading Lymphoma.

Main Symptoms

Localized symptoms

Typical manifestations are painless and progressive lymph node enlargement of the whole body or local tissues, mostly in the neck, axilla, groin and mediastinum.

Dyspnea and dysphagia caused by compression of airway and esophagus by mediastinal or neck tumor.

Gastrointestinal reactions such as abdominal pain, nausea, vomiting, blood in stool, etc. caused by invasion of gastric mucosa.

Systemic symptoms

Unexplained fever, usually body temperature is more than 38℃.

Body emaciation, weight loss of 10% in six months, skin and mucous membrane color changes, subcutaneous nodules, infiltrative plaques, etc.

Night sweats (may soak clothing).

Itchy skin, malaise.

Complications

Leukemia.

Proliferating lymphocytes enter the bone marrow in the later stages of the disease, causing more than 20% of lymphoma cells in the bone marrow is called lymphomatous leukemia, and the condition needs to be confirmed by a bone marrow smear biopsy.

Anemia

When malignant lymphoma invades the bone marrow, the bone marrow proliferation is inhibited, and the patient will have anemia; invading the gastric mucosa and causing gastrointestinal bleeding is also one of the causes of anemia.

Medical treatment

Department of Medicine

Department of Hematology

Malignant lymphoma is a disease of the hematopoietic system and can be treated in hematology or hematology.

Oncology

The Department of Oncology can provide chemotherapy, radiotherapy and targeted therapy for malignant tumors, and develop targeted treatment plans.

Gastroenterology

Some gastrointestinal lymphomas may present with symptoms such as abdominal pain and bloating, loss of appetite, etc. They can be treated in the Department of Gastroenterology or Gastroenterology.

Preparation for medical treatment

Consultation: Registration, Preparation of documents, Frequently Asked Questions

Tips for the doctor

Wear loose-fitting clothing to facilitate palpation of superficial lymph nodes throughout the body.

Preparation Checklist

Symptom list

Pay particular attention to the time of onset of symptoms, special manifestations, etc.

Are there painless enlarged lymph nodes or localized lumps?

Is there any unexplained persistent fever?

Any recent localized or generalized itching of the skin?

Medical History Checklist

Is there a family history of lymphoma or other malignant tumors in the family?

Any history of radiation therapy?

Any drug or food allergies?

Any history of infection with EBV, Helicobacter pylori (Hp), etc.?

Any immune system disorders such as rheumatoid arthritis, dry syndrome, etc.?

Any history of organ transplantation?

Checklist

Test results in the past six months, which can be brought to the doctor’s office

Specialized tests: blood smear, bone marrow image test, lymph node biopsy.

Laboratory tests: blood test, urine test, stool test, biochemical test.

Imaging tests: ultrasonography, CT scan, magnetic resonance imaging (MRI), PET-CT.

Diagnosis

Diagnosis is based on

Medical history

The patient may have a history of the following:

EBV, Helicobacter pylori, and other infections.

Autoimmune deficiency disorders or long-term use of immunosuppressive drugs such as prednisone and azathioprine.

Family history of lymphoma.

Long-term exposure to radioactive substances, chemicals, pesticides, herbicides, etc.

Clinical manifestations

Patients may have the following clinical manifestations:

Symptoms

Common symptoms include fever, night sweats, weight loss, itchy skin, and malaise.

Painless superficial lymph node enlargement.

Abdominal pain, diarrhea, abdominal distension, and intestinal bleeding.

Physical signs

Enlarged lymph nodes are mostly painless, with smooth, rounded surface, varying in size, present in isolated and scattered forms, and may fuse, ulcerate, and develop adhesions in advanced stages.

There is no bone pain.

Staging

Most types of lymphoma are staged with reference to the 2014 Lugano staging criteria.

Limited stage

Stage I.

Invasion of only a single lymph node region (I), or invasion of a single extranodal organ without lymph node involvement (IE).

Stage II

Invasion of ≥2 lymph node regions, but all ipsilateral to the diaphragm (II), which may be accompanied by limited extranodal organ involvement in the ipsilateral lymph node drainage region (IIE).

Stage II large masses, i.e., those with large masses in stage II, are usually the staging test for CT, MRI, or PET/CT.

Progressive stage

Stage III.

Invasion of the lymph node region above and below the diaphragm, or invasion of the supradiaphragmatic lymph nodes + splenic involvement (IIIS).

Stage IV

Invasion of extranodal organs beyond the lymph node drainage area (IV).

Differential diagnosis

Lymphadenitis

Necrotizing lymphadenitis and tuberculous lymphadenitis are common.

Similarities: fever, localized lymph node enlargement, etc.

Differences: Lymphadenitis is characterized by tenderness on palpation of enlarged lymph nodes, while malignant lymphoma is characterized by painless lymph node enlargement.

Infectious mononucleosis

Similarities: fever, enlarged lymph nodes.

Differences: infectious mononucleosis has a significant increase in peripheral blood lymphocytes, which can be differentiated by blood biochemistry.

Tonsillitis

Similarities: fever, enlarged lymph nodes.

Differences: tonsillitis with enlarged lymph nodes with tenderness, enlarged tonsils can be observed.

Treatment

Treatment aim: maximize clinical cure or long-term progression-free survival of the disease, maximize the improvement of patients’ quality of life.

Treatment principle: choose reasonable treatment means according to the typing, staging and prognosis of lymphoma, and carry out comprehensive treatment.

Tips: Different types of lymphoma have different treatment plans, this article only briefly describes the main treatment means, please refer to the article of each subtype of lymphoma for specific plans.

Chemotherapy

Chemotherapy is the main treatment for lymphoma. Chemotherapy for lymphoma mostly adopts multi-drug combination chemotherapy regimen. According to the characteristics of the growth cycle of lymphoma cells, cell cycle specific and cell cycle non-specific drugs are combined.

Commonly used chemotherapy drugs for lymphoma

Anthracyclines: doxorubicin, epirubicin, etc.

Alkylating agents: cyclophosphamide, isocyclophosphamide, etc.

Dihydrofolate reductase inhibitors: methotrexate, etc.

Antibiotics: bleomycin, etc.

Plant-based drugs: etoposide, vincristine, etc.

Characteristics of chemotherapy for lymphoma

Compared with solid tumors, the chemotherapy dose for lymphoma is larger, the treatment time is longer, and the patient’s general condition is relatively poorer, so it is necessary to closely monitor and promptly deal with the toxicity of myelosuppression, cardiac injury, liver and kidney damage, etc. caused by chemotherapy.

Lymphoma patients are more common among adolescents and have a higher cure rate, so the long-term toxicity caused by chemotherapy (e.g., infertility, second tumors) is also getting more attention.

Doctors usually combine chemotherapeutic agents to minimize toxic side effects while ensuring efficacy.

Commonly used chemotherapy regimens

CVP regimen: cyclophosphamide + vincristine + prednisone. Mainly used in the treatment of Hodgkin’s lymphoma.

ABVD regimen: doxorubicin + bleomycin + vincristine + dacarbazine. Mainly used in the treatment of Hodgkin’s lymphoma.

CHOP regimen: cyclophosphamide + doxorubicin + vincristine + prednisone. It is the standard treatment regimen for aggressive non-Hodgkin’s lymphoma.

R-CHOP regimen: i.e. CHOP regimen with rituximab before chemotherapy.

DHAP regimen: dexamethasone + high-dose cytarabine + cisplatin. Commonly used in second-line treatment.

Radiation therapy

Lymphoma is one of the most common radiosensitive tumors and radiotherapy plays an important role in local control, consolidation and palliative reduction of lymphoma.

Role of radiotherapy in lymphoma treatment

Radical treatment

For certain early stage lymphomas, such as early stage Hodgkin’s lymphoma without poor prognostic factors, early stage mucosa-associated tissue lymphoma, follicular lymphoma, etc., radiotherapy alone can achieve radical effect.

Consolidation of therapeutic effect

For certain aggressive lymphomas, such as diffuse large B-cell lymphoma with primary mediastinal and central origin, advanced follicular lymphoma, and condyloma, adding radiotherapy on the basis of chemotherapy can further consolidate the therapeutic effect.

Especially for patients with isolated residual lesions after chemotherapy or large masses before chemotherapy, consolidation radiotherapy can reduce local recurrence of the tumor and thus improve the long-term survival rate.

Reduce symptoms

For patients with poor tolerance to chemotherapy, especially those who have received too many courses of chemotherapy in the past or elderly patients, radiotherapy can reduce local symptoms, slow down disease progression, prolong survival time and improve quality of life.

Rescue treatment

For the spinal cord compression and gastrointestinal obstruction caused by certain lymphoma, local radiotherapy can rapidly release or reduce the compression, relieve the symptoms and finally achieve the effect of relief treatment.

Side effects of radiotherapy

Acute toxic reactions caused by radiotherapy: mucosal reactions (ulceration, leukoplakia, pain, etc.), gastrointestinal reactions (nausea, lack of appetite, vomiting) and bone marrow suppression.

Post-radiotherapy complications: radiation pneumonitis, pericarditis, myelitis, hypothyroidism, etc.

In children and adolescents, special attention also needs to be paid to the fact that radiotherapy may affect bone development.

Patients who have undergone expanded field high-dose irradiation have an increased likelihood of developing a second tumor in the radiotherapy field and need to be followed up closely at regular intervals.

Hematopoietic stem cell transplantation (HSCT)

Hematopoietic stem cell transplantation is the intravenous infusion of normal human hematopoietic stem cells into patients who have undergone pretreatment (chemotherapy/radiotherapy) to rebuild the patient’s hematopoietic and immune functions for the purpose of treating certain diseases.

The classification of HSCT can be divided into allogeneic HSCT (allo-HSCT) and autologous HSCT (auto-HSCT) according to donor genetics.

Allogeneic HSCT (allo-HSCT)

In the following cases, doctors may attempt autologous or allogeneic HSCT after high-dose combination chemotherapy with the aim of maximizing tumor cell killing and achieving longer-term remission and disease-free survival.

Age under 55 years.

Normal function of vital organs.

Short remission period.

Aggressive lymphoma that is refractory and prone to relapse.

Those who can achieve more than 3/4 lymph node shrinkage with 4 CHOP regimens.

Autologous hematopoietic stem cell transplantation (auto-HSCT)

When autologous hematopoietic stem cell transplantation is used for lymphoma treatment, there is less chance of contamination of the graft with lymphoma cells, faster recovery of hematopoietic function, and is indicated for patients with bone marrow involvement or who have undergone pelvic irradiation.

Surgical treatment

As a systemic malignant tumor of the blood system, surgical resection of lymphoma is mostly not used as a conventional treatment. Surgical intervention is still required in some special cases, mainly including:

For enlarged lymph nodes or suspected invading organs, surgical excision (or resection) biopsy is performed to clarify the pathological diagnosis.

For early primary gastrointestinal lymphoma, surgical resection can be given followed by chemoradiotherapy for consolidation.

For the complications such as spinal cord compression syndrome and cavity organ obstruction caused by lymphoma compression, decompensated surgery is feasible.

For those with hypersplenism, splenectomy can be performed if there is an indication for splenectomy, so as to improve the blood image and create favorable conditions for future chemotherapy.

Other treatments

Monoclonal antibodies

Rituximab, a classical monoclonal antibody, is often used in combination with chemotherapy, mainly for the treatment of CD20-positive NHL.

Antibody-coupled drugs (ADCs), such as vebutuximab, are used to treat relapsed/refractory CD30-positive HL.

PD-1/PD-L1 monoclonal antibodies, such as cindolizumab, karelizumab, and tirilizumab, are used for the treatment of relapsed/refractory classical Hodgkin’s lymphoma after second-line systemic chemotherapy.

Interferon

Interferon has antiviral and antitumor activity and immunomodulatory effects. It also has a partial palliative effect on mycosis fungoides, etc.

Anti-Helicobacter pylori (Hp) drugs

Gastric MALT lymphoma is treated with anti-Hp therapy in some patients with improvement of symptoms and even disappearance of lymphoma.

CAR-T therapy

CAR-T cellular immunotherapy, i.e. chimeric antigen receptor T cell immunotherapy, is currently available in China, such as Akilensai.

Akilensai is used for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after previous second-line or above systemic treatment, including diffuse large B-cell lymphoma (DLBCL) non-specific type (NOS), primary mediastinal large B-cell lymphoma (PMBCL), high-grade B-cell lymphoma, and follicular lymphoma-transformed DLBCL.

Prognosis

In general, Hodgkin’s lymphoma is slightly slower in progression, has a slightly longer course, responds better to treatment, and is even partially curable.

Non-Hodgkin’s lymphoma (except for the low-grade malignant type) tends to develop more rapidly, has a shorter disease course, has a variable response to treatment, and is prone to relapse even after remission, resulting in a poorer prognosis.

Survival rate

Hodgkin’s Lymphoma

Early-stage Hodgkin’s lymphoma has a better prognosis, for example, the 5-year survival rate of Stage I and Stage II is more than 90%.

Survival rates for advanced Hodgkin’s lymphoma need to be extrapolated based on the International Prognostic Score.

Non-Hodgkin’s Lymphoma

Non-Hodgkin’s lymphoma is a heterogeneous group of lymphomas, and the International Prognostic Index (IPI) is now commonly used as a prognostic stratification evaluation, with wide variations in survival rates, which need to be determined according to different risk groupings.

【Tips】For more on survival rates, please refer to reading the entries for each subtype of lymphoma.

Special Reminder.

The overall survival time of cancer patients can be roughly predicted by the 5-year survival rate, which refers to the proportion of patients whose tumors survive for more than 5 years after various comprehensive treatments.

The probability of recurrence after 5 years is very low and can generally be regarded as clinical cure.

Statistics such as the 5-year survival rate are only used for clinical research and do not represent the specific survival period of an individual. The expected survival time of an individual patient is affected by a variety of factors, so it is recommended to consult with the consulting physician.

Prognostic factors

The prognostic factors for different pathological types of lymphoma are different and complex. For more specific prognostic factors, please refer to the article on the various subtypes of lymphoma.

Daily

Life Management

Mindset and Mood

A good mood and mindset cannot be replaced by medications.

After diagnosis, patients may become fearful and may fear pain, abandonment and death.

Family members should pay attention to listen to the patient’s heart, improve the patient’s mental ability and relieve anxiety symptoms.

Encourage the patient’s family to give support so that the patient can face the surgery and other treatments positively with a good mindset.

During the period between treatments and after treatment, family members are advised to encourage the patient to do work and household chores that are within their ability, so as to reintegrate into their social roles.

Living

The living environment should be kept clean, with sufficient ventilation, sufficient sunlight and suitable greenhouse temperature. Disinfect the room regularly to avoid infection.

Maintain good hygiene and cleanliness to prevent accidental bodily injury. Rinse your mouth with saline solution and use a soft-bristled toothbrush after meals and before bedtime.

Maintain a positive and optimistic state of mind, reduce tension and anxiety, and avoid excessive activity and trauma for those prone to bleeding. If the lesion is in the lower limbs, try not to get out of bed to avoid fracture.

Dietary regulation

Balanced dietary structure, diversified food types and rich nutrition. Pickled, fried and deep-fried food should be avoided.

Eat more vitamin-rich vegetables and fruits, such as broccoli, tomatoes, celery, lettuce, kiwi, apples and bananas.

Eat more protein-rich foods, such as eggs, milk, lean meat and fish.

It is recommended not to eat foods that stimulate the secretion of stomach acid, such as foods that are too sweet and spicy.

Rest and Exercise

Pay attention to rest, avoid staying up late or straining, and ensure sufficient sleep and rest to reduce physical exertion and promote recovery.

When the condition improves, start with low intensity exercise such as walking and gradually resume normal activities.

Review and Follow-up

Lymphoma patients should pay attention to self-monitoring of the condition, regular follow-up, and timely consultation if there is weakness, fever, night sweats, emaciation, and enlarged lymph nodes.

Lymphoma follow-up can refer to the recommended criteria of the 2014 Lugano Conference, please follow the doctor’s instructions.

Follow-up content

Medical history, physical examination, routine laboratory tests, imaging.

For patients with more than 1 year of follow-up, minimize CT or MRI and replace them with chest radiographs and ultrasound.

PET-CT is usually not recommended as a follow-up examination.

Frequency of follow-up

Curable types

For example, diffuse large B-cell lymphoma and Hodgkin’s lymphoma are reviewed every 3 months for the first 2 years after completion of treatment.

Thereafter, review every 6 months for up to 5 years. Thereafter, 1 review every year for life.

Incurable types

Such as follicular lymphoma, set cell lymphoma, etc.

It is recommended to review every 3 to 6 months for the rest of your life.

Prevention

There is no standard prevention program for lymphoma, but paying attention to the following may help reduce the incidence of lymphoma.

Healthcare for children

The lymphatic system is related to the whole body, so it is important to guard against viruses in daily life.

During infancy, children should be immunized with various vaccines on a date-by-date basis, and from an early age, they should develop the habit of exercising to strengthen their bodies and build a line of defense against various viruses and bacteria.

Strengthening the immune system

Strengthen the immune system in many ways, eat a balanced diet, eat regularly and prevent malnutrition.

When you are sick, use medication wisely, and do not use antibiotics or corticosteroids that are harmful to the immune system unless you have to.

Adopt good living habits, enhance physical exercise, quit smoking and drinking, and avoid staying up all night.

Avoid spicy, stimulating food, eat less fried and fatty food.

Pay attention to warmth and personal hygiene to avoid viral infections.

Improve lifestyle

Purify the living environment and stay away from radiation and pollution, which tend to denature lymphocytes, so the decoration of houses emphasizes the use of environmentally friendly materials.

Avoid exposure to radiation or reduce the time of exposure to radiation, and use protective equipment scientifically.

Early detection and treatment

People with family genetic tendency need regular medical checkups for early detection and treatment.

Timely treatment of certain chronic inflammatory diseases to improve the body’s immune function.