Angioimmunoblastic T Cell Lymphoma

Overview

Angioimmunoblastic T-cell lymphoma (AITL) is a rare type of lymphoma. Lymphoma is a cancer that starts in white blood cells called lymphocytes. This specific type starts in T cells, which normally help your body fight infections. In AITL, abnormal T cells grow out of control and build up in lymph nodes and other organs, such as the spleen, liver, and bone marrow. This can cause symptoms like swollen lymph nodes, fevers, night sweats, and weight loss. It is an aggressive lymphoma, meaning it tends to grow quickly, but it often responds to treatment.

No, it is rare. It makes up about 1–2% of all non-Hodgkin lymphomas, and it is not a common cancer.

It mainly affects adults over 60, with the average age at diagnosis being around 65–70. It is slightly more common in men and in people with a weakened immune system.

Symptoms

Common symptoms

• Swollen lymph nodes (often in the neck, armpits, or groin)
• Fever that comes and goes without a clear cause
• Drenching night sweats
• Unintentional weight loss
• Feeling very tired (fatigue)
• Itchy skin rash
• Enlarged spleen or liver (feeling of fullness or discomfort in the belly)
• Easy bruising or bleeding
• Shortness of breath or cough

Causes

Main causes

• The exact cause is not known.
• The disease begins when a T cell develops a genetic change that makes it multiply out of control.
• Epstein-Barr virus (a common virus) is found in the lymph nodes of many people with AITL, but it is not yet clear whether the virus causes the lymphoma or is just a bystander.

Risk factors

• Age over 60
• Being male
• Having a weakened immune system (for example, after an organ transplant or with HIV)
• Having certain autoimmune conditions, such as rheumatoid arthritis or Sjögren's syndrome

When to see a doctor

See a doctor urgently if:

• See your doctor or visit an urgent care centre the same day if you have a fever above 38°C (100.4°F), drenching night sweats, or unintentional weight loss over a few weeks.
• Seek urgent care if you notice a lymph node or lump that is growing quickly or causing pain.

Book a routine appointment if:

• Make a routine appointment with your general practitioner (GP) if you have swollen lymph nodes, persistent fatigue, an unexplained rash, or a cough that lasts more than a few weeks.

Diagnosis

A doctor will start by asking about your symptoms, doing a physical examination, and ordering blood tests. If lymphoma is suspected, the key test is a lymph node biopsy. This means removing a small piece of a swollen lymph node, usually with a needle or a small surgical cut, and looking at it under a microscope. The biopsy is the only way to confirm the diagnosis.

Tests that may be done

• Physical exam and review of symptoms
• Blood tests to check blood counts and organ function
• Lymph node biopsy (the most important test)
• Imaging tests such as a CT scan or PET scan
• Bone marrow biopsy to see if lymphoma cells are in the bone marrow
• Molecular tests on the biopsy sample to look for specific gene changes

What to expect at your appointment

You will likely be referred to a haematologist (a doctor who specialises in blood disorders) or an oncologist (a cancer specialist). The biopsy is usually done as a day procedure. Results may take a week or more because the tissue needs careful examination. Once the results are available, your care team will discuss the diagnosis, the exact type of lymphoma, and your treatment options with you.

Treatment

Treatment for AITL usually starts soon after diagnosis because the lymphoma grows quickly. The exact plan depends on the stage of the disease, your symptoms, your age, and your overall health. Most people are treated with a combination of chemotherapy and immunotherapy. Some people may later be offered a stem cell transplant.

Self-care at home

• Follow your treatment schedule and attend all appointments.
• Rest when you feel tired and ask for help with daily tasks when needed.
• Protect yourself from infections by washing your hands often and avoiding crowded places.
• Stay hydrated and try to eat small, frequent meals if your appetite is low.
• Tell your care team about any side effects as soon as they appear.

Medical treatments

Treatment typically includes a combination of chemotherapy drugs along with an immunotherapy drug that helps your immune system recognise and attack lymphoma cells. Corticosteroids are also commonly used to reduce inflammation and help control symptoms. If you are fit enough, a stem cell transplant (sometimes called a bone marrow transplant) may be recommended after initial treatment to increase the chance of long-term remission. Clinical trials may be another option. Your specialist team will explain the most appropriate plan for you and will not use specific drug names unless you are discussing your individual prescription.

When is surgery considered?

Surgery is not a main treatment for this lymphoma. Surgery is usually only done to take a biopsy sample for diagnosis. In rare cases, surgery may be needed to relieve a complication, such as a blocked bowel or a collection of fluid in the chest or abdomen.

Living with this condition

Living with AITL involves regular check-ups, blood tests, and scans. Learn to pace yourself and plan your activities around your energy levels. It is okay to accept help from family and friends. Keep a list of questions to ask your doctor at each visit, and always report new symptoms.

Lifestyle tips

• Create a daily routine that includes planned rest breaks.
• Stay connected with family and friends — you do not have to face this alone.
• Try relaxation techniques such as deep breathing, meditation, or gentle yoga.
• Avoid smoking and limit alcohol.
• Use hand sanitizer and avoid close contact with people who have active infections.

Diet and exercise

Eat a balanced diet with plenty of protein from foods like chicken, fish, beans, and lentils. If you have trouble eating or are losing weight, ask to speak to a dietitian. Gentle exercise, like short walks, can help maintain strength, improve mood, and reduce fatigue — but always listen to your body and rest when you need to.

Mental health and emotional wellbeing

A cancer diagnosis can bring fear, anxiety, and sadness. These feelings are normal. It is important to talk about them. Your care team can connect you with a counsellor or psychologist. Joining a support group — in person or online — can also help you share experiences with others who understand.

Prevention

There is no known way to prevent this lymphoma because the cause is not fully understood. Most people who develop it have no obvious risk factors, so there is nothing they could have done differently.

Vaccines

There is no vaccine to prevent AITL. However, staying up to date with recommended vaccines, such as the flu vaccine, COVID-19 vaccine, and pneumonia vaccine, can help protect your immune system — especially during treatment. Ask your doctor or pharmacist which vaccines are appropriate for you.

Screening programmes

There is no routine screening test for this disease in people without symptoms. If you have concerns about your risk, talk to your doctor.

Complications

If left untreated

• The lymphoma can spread to the bone marrow, liver, spleen, lungs, or other organs.
• The immune system becomes weak, leading to frequent and serious infections.
• It may cause kidney or liver problems.
• Fluid can build up in the chest or abdomen, making it hard to breathe or causing severe swelling.

Long-term outlook

This is an aggressive lymphoma, but it often responds well to initial treatment. Many people achieve remission, and newer treatments have improved survival. Even if the lymphoma returns, there are further treatment options. Your care team will give you honest and personalised information about what to expect, and they will support you at every step.

Find support

International organisations

• Lymphoma Research Foundation ↗
• Lymphoma Action (UK) ↗

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.