Hormone therapy should be used with caution for lymphoma

Common clinical manifestations of malignant lymphoma include swollen lymph nodes, fever, and night sweats. There are four types of fever: low-grade fever (37.5℃-38.5℃, mostly in the early stage of the disease), intermittent fever (fever for a period of time, no fever for a period of time), remittent fever (body temperature fluctuates by more than 2 degrees in a day), and persistent high fever (above 39℃).

The causes of fever are complex. Low-grade fever needs to be differentiated from tuberculosis; intermittent fever needs to be differentiated from immune-inflammatory diseases such as Kimura's disease, and also needs to be differentiated from autoimmune diseases such as rheumatism, Sjögren's syndrome, systemic lupus erythematosus, Behcet's disease, etc.; remittent fever needs to be differentiated from infectious diseases; persistent high fever needs to be differentiated from severe infectious diseases, leukemia, necrotizing lymphadenitis, etc.

In the case of long-term fever, some doctors give patients anti-tuberculosis drugs or a lot of antibiotics, some doctors give patients intermittent or continuous glucocorticoids (commonly known as hormones), and some doctors or patients regard hormones as antipyretics and abuse them.

Hormones have a killing and inhibitory effect on lymphoma, but their effect is limited when used alone. Or if the initial treatment is effective, the tumor will be out of control if it is continued. Hormones alone cannot cure lymphoma, but instead cover up the condition. Abuse of hormones will have two major hazards:

First, hormones can temporarily reduce fever and shrink lymph node nodules in lymphoma, but later biopsies cannot make a clear diagnosis due to the atypical tissue structure or necrosis of tissue cells, which will cause confusion in future diagnosis and difficulties in future treatment. Some doctors perform lymph node biopsies or bone punctures after giving patients hormones for a period of time, and the results report that the tissue is disintegrated and necrotic, the structure is difficult to identify, or the cell morphology is difficult to determine the type or source.

Second, hormones can also shrink lymphomas with immune inflammation. In clinical practice, it is often seen that after the use of hormones, the fever subsides and the tumor shrinks, but the patient often does not seek further diagnosis and treatment. After a period of time, the fever recurs and the tumor rapidly increases. The patient is eventually diagnosed with lymphoma, but the disease is already in the late stage, missing the best time for treatment.

Therefore, hormones should not be used as antipyretics. Hormones should be used with caution and for appropriate indications. When performing lymph node biopsy and bone puncture, hormones should be discontinued for more than 5-7 days to prevent confusion in the test results.