What is diffuse large B cell lymphoma? — Diffuse large B cell lymphoma, called "DLBCL," is one type of lymphoma. Lymphoma is a cancer of lymphocytes, which are infection-fighting cells of the body's lymphatic system. The lymphatic system is made up of organs all over the body that make and store cells that fight infection (figure 1).
When people have DLBCL, their lymphocytes become abnormal and grow out of control. These cells can travel to different parts of the body. Often, the abnormal cells collect in small, bean-shaped organs called lymph nodes. This causes the lymph nodes to swell.
DLBCL is a common type of lymphoma and usually happens in older people. It grows quickly, so it needs to be treated quickly.
What are the symptoms of DLBCL? — Most people with DLBCL first notice one or more swollen lymph nodes. These swollen nodes are often in the neck, groin, or belly. You might be able to feel them under the skin but they are usually not painful. People with DLBCL can also have:
Night sweats that soak their clothes
Is there a test for DLBCL? — Yes. Your doctor or nurse will talk with you and do an exam. He or she will also do:
A lymph node biopsy – A doctor will remove one of the swollen lymph nodes. Then another doctor will look at the cells under a microscope to see if cancer cells are present.
What is lymphoma staging? — Lymphoma staging is a way in which doctors find out how far the lymphoma has spread in the lymphatic system or in the body. The right treatment for you depends a lot on the stage of your lymphoma.
To find out how far your DLBCL has spread, your doctor will do an exam, blood tests, and an imaging test, such as a CT or PET scan. Imaging tests create pictures of the inside of the body.
Your doctor might also do a bone marrow biopsy. For this test, a small sample of bone marrow (the tissue in the center of your bones) will be examined under a microscope to check for lymphoma.
How is DLBCL treated? — People with DLBCL are usually treated with:
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
Medicines called "immunotherapy" – These medicines kill cancer cells by attacking the lymphoma cells.
Radiation therapy – Radiation kills cancer cells.
All people with DLBCL get chemotherapy and immunotherapy. Some people will also get radiation therapy.
What happens after treatment? — After treatment, your doctor will check to see if your DLBCL is gone. He or she will talk with you, do an exam, and order blood tests. He or she might also order an imaging test.
If your doctor does not see cancer in your blood or body, then he or she will check every so often to see if the DLBCL has come back. Regular follow-ups will include talking with your doctor and having exams. Sometimes, your doctor will also do blood tests and imaging tests.
You should also watch for the symptoms listed above, such as swollen lymph nodes, fever, weight loss, or night sweats. Tell your doctor or nurse if you have those symptoms, because having those symptoms could mean that the cancer has come back.
What happens if the DLBCL comes back? — If the DLBCL comes back, or if it never went away after treatment, you might have more chemotherapy, immunotherapy, or a bone marrow transplant. A bone marrow transplant is a treatment that replaces cells in the bone marrow that are killed by chemotherapy or radiation. It is also called a "stem cell transplant."
What else should I do? — It's important to follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for DLBCL involves making many choices, such as what treatment to have and when.
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the risks to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15855 Version 10.0
Release: 28.2.2 - C28.105
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