general description
What is diffuse large B-cell lymphoma?
Diffuse large B-cell lymphoma (DLBCL) is a fast-growing blood cancer and the most common form ofNon-Hodgkin lymphoma. There are different forms of DLBCL, which occur when a number of different genetic changes, or mutations, turn healthy cells into cancer cells.
Health professionals treat most types of GBDL by combining several anticancer drugs. This treatment usually eliminates the signs and symptoms of DLBCL and cures the condition. The combination of drugs does not work in all cases of diffuse large B-cell lymphoma. Medical researchers are investigating different treatments for DLBCL that do not respond to treatment or come back.
How will diffuse large B-cell lymphoma affect my body?
To understand how DLBCL may affect you, it may help to know more about non-Hodgkin lymphoma. These conditions occur whenwhite blood cellsknown as lymphocytes undergo mutations or changes. These cells include B cells, T cells, and natural killer (NK) cells.
There are two categories of non-Hodgkin lymphoma: B-cell lymphoma and T/NK-cell lymphoma. Diffuse large B-cell lymphoma is aB cell lymphoma.
B-cell lymphomas commonly affect yourlymphatic system. Your lymphatic system is a network of tissues, vessels, and organs that work together to move a colorless, watery fluid called lymph back into the bloodstream. Lymph contains B cells (B lymphocytes). B cells produce antibodies. Antibodies are proteins that attack invaders such as viruses and bacteria.
Normally, after fighting off the infection, the healthy B cells die. B-cell lymphoma occurs when healthy B cells become fast-growing cancer cells that do not die as they should. Cancer cells multiply and eventually overwhelm healthy cells.
In diffuse large B-cell lymphoma, cancerous B cells can appear in the lymph nodes, but in some cases they can appear in almost any organ, including the digestive tract, thyroid, skin, breast, bone, or brain. . Diffuse large B-cell lymphoma is aggressive, which means it can spread very quickly.
Is it a serious disease?
It could be depending on your situation. One study showed that a combination of anticancer drugs used as first-line or first-line treatment cured 90% of people with early-stage or limited-stage lymphoma. (Early-stage cancer is cancer that has not spread.) The same treatment has helped up to 60% of people with a more advanced form of diffuse large B-cell lymphoma. However, combination treatment does not cure all DLBCL, nor can it prevent the condition from coming back (recurring).
Is diffuse large B-cell lymphoma common?
No, it isn't, at least when compared to other types of cancer. According to the National Cancer Institute, about 6 out of 100,000 people were diagnosed with DLBCL in 2020. For comparison, this year, 19 out of 100,000 people were diagnosed with some type of non-Hodgkin lymphoma, and about 500 of every 100,000 people were diagnosed with cancer affecting some part of their body.
Who is affected by this disease?
Diffuse large B-cell lymphoma usually affects people in their 60s. It affects whites more than blacks.
symptoms and causes
What are the symptoms of diffuse large B-cell lymphoma?
The symptoms that most people notice areswollen lymph nodesin the neck, armpits, or groin. You may notice a lump or mass that does not go away and seems to be growing. Other symptoms are sometimes:
- unexplained fever: A fever that stays above 103 degrees Fahrenheit (39.5 degrees Celsius), lasts more than two days, or comes back may be a sign of a serious problem.
- heavy night sweats: This is a sweat so intense that it soaks your sheets.
- unexplained weight loss: That's losing body weight without trying. Losing 10% of your total body weight in six months is a sign of unexplained weight loss.
It is important to remember that these are common symptoms associated with many different medical conditions. Having any or all of these symptoms does not mean you have diffuse B-cell lymphoma. However, you should see a doctor any time you notice changes in your body that last for several weeks.
What causes diffuse large B-cell lymphoma?
Diffuse large B-cell lymphoma occurs when B cells mutate. These are acquired gene mutations, meaning you develop them during your lifetime rather than being born with them.
Medical researchers aren't sure what triggers these mutations, but a family history of DLBCL could be a risk factor. A risk factor is an activity or condition that increases the risk of developing a disease. Other risk factors may be:
- Certain viruses, includingEpstein-Barr virus, Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C.
- Immunosuppressive drugs taken after organ transplants.
- Autoimmune diseases.
- Immunodeficiency.
- Elevated body mass index in young adults.
- Agricultural pesticides.
- Ionizing radiation.
diagnosis and tests
How do health professionals diagnose diffuse large B-cell lymphoma?
Health professionals use several different blood tests and an imaging test to diagnose this condition. they tooTry againto understand if certain mutations or changes are part of the development of a particular case of diffuse large B-cell lymphoma.
Tests that health professionals may use include:
- Detailed physical examination.
- Complete blood count (CBC) with differential.
- Comprehensive Metabolic Profile (CMP).
- Lactate dehydrogenase (LDH).
- Human immunodeficiency virus (HIV/AIDS).
- Hepatitis B and hepatitis C viruses.
- lymph nodesBiopsy.
- positron emission tomography(PET) meshand/or computed tomography (CT).
Why is genetic testing important in diagnosing DLBCL?
Diffuse large B-cell lymphoma occurs when genes mutate or change. In DLBCL, mutations can affect many different genes and chromosomes to produce different types of diffuse large B-cell lymphomas.
- Diffuse Large B-Cell Lymphoma (DLBCL-NOS): NOS means "Not Otherwise Specified". There are two forms of DLBCL-NOS: germinal center B cell-like (GCB) and activated B cell-like (ABC). These forms have different genetic makeups that affect how they respond to treatment. GCB represents approximately 50% of DLBCL-NOS and is more responsive to treatment than ABC. Other subtypes include dual lymphoma and triple lymphoma, named for the combined effect of gene mutations and chromosomal changes that create cancer cells.
- Primary B-cell lymphoma of the mediastinum: People with this subtype have rapidly growing central thoracic lymphoma. They may also have lymphoma tumors in other parts of their body.
- CNS lymphoma: This diffuse large B-cell lymphoma affects the human central nervous system.
Stages of diffuse large B-cell lymphoma
The test results help providers with the staging of the cancer. use health professionalsCancer staging systemsto develop treatment plans and estimate the prognosis or expected outcome. Here is some information about the DLBCL levels:
Fase I
- There is a lymphoma in a lymph node area or in a lymphoid organ. Your thymus, spleen, and tonsils are lymphatic organs.
- Stage IE: There is lymphoma in only one area of a single organ outside the lymphatic system.
Stage II
- Lymphoma is present in two or more groups of lymph nodes on the same side (above or below) of the diaphragm, the band of muscle that separates the chest and abdomen.
- Or the lymphoma is part of a group of lymph nodes and is in one area of a nearby organ. At this stage, the lymphoma may also affect other lymph nodes near the diaphragm.
Greenhouse 3
- There is lymphoma in the lymph node areas on both sides (above and below) of the diaphragm.
Stage IV
- There is lymphoma in at least one area outside the lymphatic system, e.g. B. in the bone marrow, liver, or lungs.
understand the stages of cancer
Health professionals use cancer staging systems to plan treatment for diffuse large B-cell lymphoma.
Some people with cancer can be confused and intimidated by a system that describes their disease in terms of a formula of letters and numbers or risk factors that place them in one category or another. They may even feel that the stage or category of their condition defines who they are.
In this case, talk to your provider. They will understand why you feel this way and will be happy to answer your questions about cancer staging systems.
management and treatment
How do health professionals treat diffuse large B-cell lymphoma?
The default treatment is R-CHOP. Combine themonoclonal antibodydrug rituximab with threechemotherapyMedications and a drug that helps kill lymphoma cells.
This treatment is safe and effective, but it doesn't always work or keep DLBCL from coming back. (Studies show that about 10% to 35% of people taking R-CHOP experience flare-ups or recurrent illness.) When this happens, health professionals may recommend the following treatments:
- second line treatment andautologous stem cell transplant: Second-line therapy is intensive treatment with combination anticancer drugs.
- chimeric antigen receptor(COCHE) T-Zelltherapie: This treatment may be helpful for people with diffuse large B-cell lymphoma that comes back after treatment.
- Targeted Therapy: This treatment targets the gene changes or mutations that cause diffuse large B-cell lymphoma.
prevention
Can I reduce my risk of developing diffuse large B-cell lymphoma?
A risk factor is an activity or condition that increases your risk of developing a condition. There are risk factors for DLBCL that you cannot control, such as: B. an autoimmune disease or immunodeficiency. And there are risk factors you can avoid, such as: B. developing certain infections.
Avoiding risk factors can help, but there's no guarantee that you won't develop DLBCL. This is because this condition occurs when certain genes mutate and create cancer cells. These are acquired gene mutations, meaning you develop them during your lifetime rather than being born with them. Medical researchers aren't sure why these mutations occur or what specific role risk factors may play. Additional risk factors for diffuse large B-cell lymphoma include:
- Immunosuppressive drugs taken after organ transplants.
- Exposure to agricultural pesticides.
- Exposure to ionizing radiation.
Outlook / Forecast
What can I expect if I have diffuse large B-cell lymphoma?
That depends on your situation. As with many types of cancer, medical professionals are more successful treating early-stage DLBCL than advanced or late-stage cancer that has spread. In general, people who are free of cancer two years after diagnosis can expect to live as long as most people in their age group.
However, diffuse large B-cell lymphoma can come back. And there are different forms of DLBCL that are more difficult to treat. If you have this condition, your doctor is your best source of information about what to expect.
Are there treatments that can cure this condition?
Initial or first-line treatment often cures people with early-stage diffuse large B-cell lymphoma. (In this case, "cure" means that the treatment got rid of all the signs and symptoms of the cancer.) Initial or first-line treatment cures about 60% of people with advanced or late-stage GBDL.
What are the survival rates for diffuse large B-cell lymphoma?
According to the National Cancer Institute, 64.6% of people with DLBCL are alive five years after diagnosis. (Relative survival rates are estimates based on large populations.)
As with many types of cancer, survival rates are increasing for people with early-stage cancer. In this case, 79.5% of people with stage I DLBCL are alive five years after diagnosis. People often already have advanced cancer when they are diagnosed. In this case, 54.7% of people with stage IV DLBCL are alive five years after diagnosis.
It is important to remember that survival rates are estimates. They are based on the experiences of large groups of people with different forms of DLBCL, at different times in their lives, and with different general health conditions.
Survival estimates can be helpful, but your doctor is your best point of contact if you have questions about what to expect.
to live with
How do I take care of myself?
As with most cancers, living with diffuse large B-cell lymphoma can be stressful and exhausting. It's important that you do what you canTake carethroughout your treatment for diffuse large B-cell lymphoma. Here are some suggestions:
- iss einshealthy nutrition.
- rest as much as you can.
- Develop an exercise routine.gentle exerciseit can help you deal with stress.
- find support. Diffuse large B-cell lymphoma is a rare disease. You may feel that no one understands what you are going through. Connecting with people who are in your situation can help.
When should I see my doctor?
You will see your doctor throughout the treatment. They monitor your overall health. They will assess how you are responding to treatment and whether the treatment is working. You can see your provider every three to four months for the first two years and less often for the next three years. This is because diffuse large B-cell lymphoma can come back. Contact your doctor if you notice any changes in your body that could mean your condition has returned.
When should I go to the emergency room?
Cancer treatment can have serious side effects. Your doctor may have prescribed medicine to treat your side effects. You should go to the emergency room if:
- Side effects that are stronger than expected.
- Fever over 100.4 degrees Fahrenheit (38 degrees Celsius).
- chills that do not go away
- Womb of Dor.
- Persistent diarrhea.
What questions should I ask a doctor about diffuse large B-cell lymphoma?
Diffuse large B-cell lymphoma is a rare disease. If you have this condition, you should ask your doctor some of the following questions:
- What type of diffuse large B-cell lymphoma do I have?
- What stage is this cancer?
- What treatment do you recommend?
- What side effects does the treatment have?
- What can I expect from the treatment?
- Will this treatment cure my condition?
- What is the probability that this condition will recur after treatment?
- What treatments are available if my condition returns?
- Are there clinical trials for different treatments?
A note from the Cleveland Clinic
Diffuse large B-cell lymphoma (DLBCL) is a fast-growing blood cancer and the most common form of non-Hodgkin lymphoma. In most cases, medical professionals can cure this condition using a combination of anticancer drugs as first-line or first-line therapy. (In this case, "cure" means that the treatment got rid of the signs and symptoms of the cancer.)
Unfortunately, there are situations in which the initial therapy does not work. Diffuse large B-cell lymphoma may come back after treatment. When this happens, health professionals have various treatments that can be successful.
At the same time, medical researchers are testing many treatments that may do more to help people with DLBCL. If you have this condition and want information about newer treatments, ask your doctor about joining a clinical trial.
FAQs
What is the life expectancy of someone with diffuse large B cell lymphoma? ›
| SEER Stage | 5-Year Relative Survival Rate |
|---|---|
| Localized | 74% |
| Regional | 73% |
| Distant | 57% |
| All SEER stages combined | 64% |
Symptoms. Symptoms can start or get worse in just a few weeks. The most common symptom is one or more painless swellings. These swellings can grow very quickly.
What are the chances of diffuse large B cell lymphoma coming back? ›Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Approximately 30% to 40% of patients will develop relapsed/refractory (R/R) DLBCL, leading to significant morbidity and mortality.
Is diffuse large B cell lymphoma curable? ›DLBCL is a fast-growing, aggressive form of NHL. DLBCL is fatal if left untreated, but with timely and appropriate treatment, approximately two-thirds of all people can be cured.
What is the 10 year survival rate for diffuse large B cell lymphoma? ›Ten-year OS and PFS rates were 51 and 72%, respectively; median OS was 124 months and median PFS was not reached. Ten-year OS rates were 80 and 87% in low-risk and 'very good' prognosis groups, respectively, and 30 and 37% in high-risk and poor prognosis patients, respectively.
What is the best treatment for diffuse large B cell lymphoma? ›Diffuse large B-cell lymphoma
Most often, the treatment is chemotherapy (chemo), usually with a regimen of 4 drugs known as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), plus the monoclonal antibody rituximab (Rituxan). This regimen, known as R-CHOP, is most often given in cycles 3 weeks apart.
Diffuse large b cell lymphoma stage 4 survival rate for 5 years by stage according to SEER: Localized: 73% Regional: 73% Distant: 57%
What foods help fight lymphoma? ›- Lean meats such as chicken, fish, or turkey.
- Eggs.
- Low-fat dairy products such as milk, yogurt, and cheese or dairy substitutes.
- Nuts and nut butters.
- Beans.
- Soy foods.
Stages of DLBCL
Stage 1: The cancer affects only one area — either a single organ or a single cluster of lymph nodes. Stage 2: The cancer affects two or more areas on the same side of the diaphragm. Stage 3: The cancer affects areas on both sides of the diaphragm.
Which type of remission your doctor aims for depends on the kind of B-cell lymphoma you have. Some forms of the disease have a good chance of going into complete remission. With others, even partial remission is considered a success.
What are the early signs of DLBCL relapse? ›
Among the signs of relapse of DLBCL are enlarged lymph nodes, night sweats, unexplained fever, and unintentional weight loss.
How do you prevent lymphoma from coming back? ›Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight might help, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of lymphoma or other cancers.
How do you beat B-cell lymphoma? ›Chemotherapy is the main way to treat most types of B-cell lymphoma. You can get this on its own, or combine it with radiation or immunotherapy. Chemo uses drugs to kill fast-dividing cells in your body, including cancer cells. You get this medicine through a vein (IV), or you take it as a pill by mouth.
What is the main cause of diffuse large B-cell lymphoma? ›Diffuse large B-cell lymphoma (DLBCL) is a fast-growing blood cancer and the most common form of non-Hodgkin lymphoma. There are different forms of DLBCL that happen when several different genetic changes, or mutations, turn healthy cells into cancerous cells.
Why do people get diffuse large B-cell lymphoma? ›The causes of diffuse large B-cell lymphoma (DLBCL) are mostly unknown. But some things may increase your risk of developing it. drugs called immunosuppressants – these are wised after an organ transplant, or to treat autoimmune disease.
Can large B cell lymphoma spread to the brain? ›One of the most serious complications for a patient with diffuse large B-cell lymphoma who presents with disease outside the central nervous system (CNS) is the development of CNS metastasis. This usually involves the cerebrospinal fluid and meninges, but solid parenchymal brain metastasis can also occur.
Who gets diffuse large B-cell lymphoma? ›This subtype of DLBCL typically develops in people over 50, although it can affect younger people. It is linked to a virus called Epstein–Barr virus (EBV), which infects B cells. Most people have been infected with EBV at some point in their lives, but it doesn't usually cause any symptoms.
How long is chemo for B cell lymphoma? ›You might have a short course of chemotherapy and a targeted drug, followed by radiotherapy to the affected lymph nodes. A short course of treatment usually takes about 6 to 12 weeks.
What foods should I avoid with B cell lymphoma? ›Foods to avoid
Foods to skip or cut back on include: Animal fats like fatty meats, processed meats, lard and butter. Sugar, including added sugars in desserts, sweetened drinks and processed foods. White, refined grains like white bread, pasta and rice.
Stage 4 non-Hodgkin's diffuse large B-cell lymphoma has a five-year relative survival rate of 57%15. Stage 4 non-Hodgkin's follicular lymphoma has a five-year relative survival rate of 86%15. Stage 4 Hodgkin's lymphoma has a five-year relative survival rate of 82%16.
Is Stage 4 B-cell lymphoma curable? ›
The survival rate of stage 4 lymphoma is lower than that of the other stages, but doctors can cure the condition in some cases. People with a diagnosis of stage 4 lymphoma should discuss their treatment options and outlook with their doctor.
What is the best vitamin for lymphoma? ›In addition to the effects on calcium homeostasis, vitamin D has important immunologic effects, which may be the primary mechanism of activity in lymphomas, including Hodgkin lymphoma.
What drinks are good for lymphoma? ›Drink plenty of water throughout the day to prevent dehydration and reduce treatment side effects. Drink broths or sports drinks to replace electrolytes, such as sodium and potassium.
What fruits are best for lymphoma? ›Eating a nutritious diet. There's no specific diet for people living with Hodgkin's lymphoma, but you can always aim to plan well-balanced and nourishing meals. A balanced diet will include: fruits and vegetables, such as berries, citrus fruits, broccoli, and leafy greens.
Where does diffuse large B-cell lymphoma spread? ›Despite its name, the disease can involve the trunk, arms, legs, buttocks, or anywhere on the body. These lymphomas can also spread to areas other than just the skin. Epstein-Barr virus (EBV)-positive DLBCL of the elderly: This form of DLBCL usually occurs in patients who are age 50 or older and test positive for EBV.
What is the outlook for diffuse large B-cell lymphoma? ›Around 10-15% of people with DLBCL (10 to 15 people in every hundred) have refractory disease, which means the DLBCL doesn't respond to standard treatment. And for between 20% and 30% of people (20 to 30 people in every hundred), the DLBCL will come back after remission (it'll relapse), usually in the first two years.
What is the cure rate for B-cell lymphoma? ›Approximately 65% of people diagnosed with the most common form of B-cell lymphoma are alive five years after diagnosis and considered cured.
How long is treatment for large B-cell lymphoma? ›The most widely used treatment for DLBCL presently is the combination known as R-CHOP (rituximab [Rituxan], cyclophosphamide [Cytoxan], doxorubicin [Adriamycin], vincristine [Oncovin], and prednisone) The R-CHOP regimen is usually given in 21-day cycles (once every 21 days) for an average of 6 cycles.
Do B cells regenerate after chemo? ›B cells demonstrated particularly dramatic depletion, falling to 5.4 % of pre-chemotherapy levels. Levels of all cells recovered to some extent, although B and CD4+ T cells remained significantly depleted even 9 months post-chemotherapy (p < 0.001).
How many cycles of chemo does a DLBCL take? ›Most patients with DLBCL receive treatment in 6 cycles, spaced 3 weeks apart. Each treatment cycle includes CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) along with rituximab.
Does DLBCL run in families? ›
Non-Hodgkin lymphoma isn't infectious and isn't thought to run in families, although your risk may be slightly increased if a close relative (such as a parent or sibling) has had lymphoma. Non-Hodgkin lymphoma can occur at any age, but a third of cases are diagnosed in people over 75.
Can stress cause lymphoma to return? ›From the available research, there isn't strong evidence that stress can worsen lymphoma or any type of cancer, or that it can make it come back (relapse).
What is the root cause of lymphoma? ›Like all cancers, lymphoma is the result of mutations in DNA that instruct the cells on how to grow, and the cells often grow out of control and live longer than they should. These disease cells then continue to multiply at a rapid rate, producing more disease cells.
Can you completely get rid of lymphoma? ›Overall, treatment for Hodgkin lymphoma is highly effective and most people with the condition are eventually cured.
Is lymphoma B curable? ›They are usually not curable with standard treatments, but many people can live a long time (even decades) with them. Sometimes, these can turn into a more aggressive (fast-growing) type of lymphoma over time.
Can you starve lymphoma? ›You Can't 'Starve' Cancer, but You Might Help Treat It With Food. There is no single “cancer diet.” Cancer cells grow in distinctive patterns that defy normal limitations. That growth activity requires energy, and so cancer cells metabolize nutrients in different ways from the healthy cells around them.
What does B-cell lymphoma do to your body? ›In B-cell lymphoma, some lymphocytes are no longer healthy and do not fight infection. Instead, they grow out of control, crowding out the normal cells and causing the lymph nodes to get bigger. As the disease advances, it may spread to the bone marrow, central nervous system, liver, spleen and reproductive organs.
What causes death in diffuse large B cell lymphoma? ›Median survival of 90-day and 180-day mortality patients were 19 days and 33 days. Among 25 patients with 90-day mortality, causes of death included rapid progression(48%), sepsis(32%), GI bleeding (32%), tumor lysis syndrome(24%), and withdrawal of care as not a treatment candidate with co-morbidities(16%).
What is the progression of diffuse large B cell lymphoma? ›Stages of DLBCL
Stage 1: The cancer affects only one area — either a single organ or a single cluster of lymph nodes. Stage 2: The cancer affects two or more areas on the same side of the diaphragm. Stage 3: The cancer affects areas on both sides of the diaphragm.
These won't necessarily be painful. The most common place for you to notice these would be in your neck, armpit or groin (at the top of your leg on the inside, where it meets your body). In these areas the lymph nodes lie just under the skin, so you're more likely to notice if they're swollen.
Can large B-cell lymphoma spread to the brain? ›
One of the most serious complications for a patient with diffuse large B-cell lymphoma who presents with disease outside the central nervous system (CNS) is the development of CNS metastasis. This usually involves the cerebrospinal fluid and meninges, but solid parenchymal brain metastasis can also occur.