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Ears, Nose, and Throat in Leukemias and Lymphomas: History
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Subjects: Immunology
Contributor: Pinelopi Samara , Michail Athanasopoulos , Ioannis Athanasopoulos

Leukemias and lymphomas, encompassing a spectrum of hematologic malignancies, often exhibit manifestations in various tissues and organs, including the ears, nose, and throat (ENT) region, extending beyond the typical sites of bone marrow and lymph nodes. This entry explores these interactions, considering disease-related symptoms and treatment effects. ENT symptoms, such as otalgia, hearing loss, and nasal obstruction, may arise from direct infiltration or treatment complications, with chemotherapy-induced ototoxicity being particularly characteristic. Furthermore, immunotherapy complications, including cytokine release syndrome and mucosal irritation, can also contribute to ENT symptoms. Additionally, targeted therapy and radiotherapy can lead to mucosal dryness, dysphonia, and radiation-induced otitis media. Patients with hematologic malignancies are especially vulnerable to various ENT infections, including bacterial, viral, and fungal infections, due to compromised immunity resulting from both the disease and its treatments. Conditions such as rhinosinusitis, otitis media, and pharyngitis pose significant management challenges. Moreover, patients undergoing hematopoietic stem cell transplantation (HSCT) face unique ENT considerations, including mucositis, opportunistic infections, and graft-versus-host disease in cases of allogeneic HSCT. These patients require specialized pre-transplant evaluations, meticulous post-transplant surveillance, and tailored assistance to mitigate complications. This entry underscores the importance of a multidisciplinary approach that integrates diagnostics, pharmacological interventions, and supportive care to address both disease-related and treatment-induced ENT manifestations. Further research is needed to refine management strategies and improve outcomes in this complex clinical population.

  • leukemia
  • lymphoma
  • chemotherapy
  • immunotherapy
  • radiotherapy
  • ototoxicity
  • HSCT
Leukemias and lymphomas represent a diverse group of hematologic malignancies with highly variable clinical presentations. Symptoms commonly include fatigue, fever, night sweats, unintentional weight loss, petechiae, bone pain, and lymphadenopathy [1][2]. While traditionally associated with bone marrow and lymph node involvement, these malignancies can also present in extramedullary sites, including the ears, nose, and throat (ENT) region [3]. Diagnosis typically involves a combination of blood tests, bone marrow or lymph node biopsies, and imaging studies. The clinical management of leukemias and lymphomas is complex due to their heterogeneous characteristics, clinical variability, and evolving treatment approaches [4][5][6]. Treatment strategies depend on the specific type and stage of the disease, as well as molecular and cytogenetic features, and may include chemotherapy, radiation therapy, targeted therapy, immunotherapy, and hematopoietic stem cell transplantation (HSCT) [7][8][9][10]. The primary goals of treatment are to control disease progression, achieve remission and improve overall survival while minimizing treatment-related toxicity. The ENT region can exhibit a range of symptoms and complications in patients with hematologic malignancies. Direct infiltration by leukemia or lymphoma cells can lead to symptoms such as otalgia, hearing loss, nasal obstruction, and dysphagia [11][12]. Additionally, treatment modalities can introduce challenges, including ototoxicity, mucosal dryness, and radiation-induced otitis media [13][14]. Patients with hematologic malignancies are also more susceptible to ENT infections-including bacterial, viral, and fungal, due to compromised immunity from both the disease and its treatments [15]. These infections, along with common conditions like sinusitis and pharyngitis, pose significant management challenges, necessitating tailored care strategies. Furthermore, patients undergoing HSCT may experience ENT complications such as mucositis and opportunistic infections. Graft-versus-host disease (GvHD) is specific to allogeneic HSCT, where donor immune cells attack the recipient’s tissues, a complication not seen in autologous HSCT [16]. The complexities of pre-transplant evaluation, post-transplant surveillance, and individualized support are crucial for minimizing complications and optimizing outcomes in this patient population. Given these intricacies, a multidisciplinary approach that integrates diagnostics, pharmacological interventions, and supportive care is essential for addressing both disease-related and treatment-induced ENT manifestations.
This entry aims to investigate the complex relationship between leukemias, lymphomas, and the ENT system, emphasizing the need for further research into preventive strategies and innovative therapies targeting ENT complications-an area often underrepresented in existing literature. Through comprehensive analysis, the entry seeks to improve understanding and optimize management strategies to enhance care and outcomes for individuals with hematologic malignancies involving the ENT region.

This entry is adapted from the peer-reviewed paper 10.3390/encyclopedia4040123

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