What are the other Names for this Condition? (Also known as/Synonyms)

• Diffuse Histiocytic Lymphoma (B-Cell)
• Large Cell Lymphoma (B-Cell)
• Large Lymphoma (B-Cell)

What is Diffuse Large B-Cell Lymphoma? (Definition/Background Information)

• Lymphoma is a type of blood cancer stemming from uncontrollably dividing lymphocytes (type of white blood cells). There are two types of lymphomas:
  • Hodgkin lymphoma
  • Non-Hodgkin lymphoma
• Diffuse Large B-Cell Lymphoma (DLBCL) is a non-Hodgkin lymphoma that is a fast-growing, malignant lymphoma of the B-cells (one of the white blood cells)
• It can originate and spread, either within the lymph nodes, or in other regions like, the skin, thyroid, bone, breast, testes, and the gastrointestinal tract. DLBCL is normally diagnosed using a biopsy of the swollen lymph nodes
• Chemotherapy using combination drugs, termed as “R-CHOP”, form the usual and often successful method of treatment. However, the prognosis depends on many factors

Who gets Diffuse Large B-Cell Lymphoma? (Age and Sex Distribution)

• Diffuse Large B-Cell Lymphoma, generally affects the elderly adult population, around the median age of 70 years
• Sometimes, young adults and children are also affected
• No specific gender, race, or ethnic predisposition is observed

What are the Risk Factors for Diffuse Large B-Cell Lymphoma? (Predisposing Factors)

The International Prognostic Index, for aggressive non-Hodgkin Lymphoma, lists a few factors that determine the overall risk:

• Age over 60 years
• Elevated level of serum lactate dehydrogenase - LDH (a type of enzyme)
• Performance status, i.e. the overall health condition of the individual, which could range from being fully active (low risk) to being completely disabled (very high risk)
• Individual, who have already suffered from lymphoma, or other types of blood cancers, may have a relapse or a recurrence
• Presence of an immunodeficiency syndrome, like AIDS, is a high risk factor
• Those infected with Epstein-Barr virus are also prone to Diffuse Large B-Cell Lymphoma

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Diffuse Large B-Cell Lymphoma? (Etiology)

• Lymphocytes are a type of white blood cells that are responsible for providing immunity in the human body. B-cells and T-cells are the two different types of lymphocytes
• When under certain circumstances, the lymphocytes grow and multiply abnormally, it leads to a condition, called as lymphoma - a most common type of blood cancer. There are 2 types of lymphoma - Hodgkin lymphoma and non-Hodgkin lymphoma
• An aggressive form of the non-Hodgkin lymphoma is Diffuse Large B-Cell Lymphoma. The exact cause of DLBCL formation is unknown
• The cancer cells in this blood condition do not group together, but spread-out aggressively (termed diffuse) to other lymph nodes

What are the Signs and Symptoms of Diffuse Large B-Cell Lymphoma?

Among the early signs of Diffuse Large B-Cell Lymphoma, is the rapid swelling-up of the lymph nodes, located in the armpits, groin region, neck, etc. These may be painful in some cases.

The other signs and symptoms include:

• Weight loss and fatigue
• Fever
• Sweating at night (recurrent)
• Low lymphocyte count, established by a blood test
• Frequent infections

How is Diffuse Large B-Cell Lymphoma Diagnosed?

Diffuse Large B-Cell Lymphoma diagnosis is performed by obtaining biopsy samples from the tumor formed at the lymph nodes, and examining them under a microscope to detect the cancerous cells. Other methods to aid in the study include:

• Physical exam with study of medical history
• Blood test, such as complete blood count (CBC)
• LDH test
• Bone marrow biopsy
• CT scans of various parts of the body
• PET scans to determine the extent of lymphoma involvement in the body

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Diffuse Large B-Cell Lymphoma?

Complications with Diffuse Large B-Cell Lymphoma are mainly related to the chemotherapy treatment. These include:

• Use of chemotherapy for DLBCL causes many side effects, like dizziness, vomiting, appetite loss, mouth ulcers, and hair loss
• By damaging healthy cells, the individual is more open or vulnerable to secondary infections
• The treatment can also cause infertility in men and women. Hence, measures to protect the individual’s fertility must be considered, before starting chemotherapy

How is Diffuse Large B-Cell Lymphoma Treated?

• The standard and established method for treating Diffuse Large B-Cell Lymphoma is through chemotherapy and using combination medication, called “R-CHOP”
• There is a high success rate of 50-80% with R-CHOP medication. R-CHOP is rituximab–cyclophosphamide, doxorubicin, vincristine, and prednisone
• Sometimes, radiotherapy is administered, before or after chemotherapy, depending on the stage of the lymphoma
• In case of a relapse, the patients may be put on high-dosage drug therapy. Rarely, on healthier patients, a stem cell transplant may be performed

How can Diffuse Large B-Cell Lymphoma be Prevented?

• Understanding and taking care of the risk factors, and holding periodic health check-ups are recommended, to prevent the onset of Diffuse Large B-Cell Lymphoma
• In order to avoid a relapse, or be prepared for a recurrence, the entire diagnosis, treatment process, drugs administered, etc. should be well-documented and follow-up measures initiated
• Regular medical screening at periodic intervals with blood tests, scans, and physical examinations, are mandatory for those who have already endured the condition

What is the Prognosis of Diffuse Large B-Cell Lymphoma? (Outcomes/Resolutions)

• Diffuse Large B-Cell Lymphoma is an aggressive blood cancer with an above-average mortality rate. Factors that influence a positive outcome include the response to treatment, genetic factors, risk factors, etc.
• The combination chemotherapy drugs used, may have some severe side effects (like cardio-toxicity). This chiefly impacts the elderly adults, or those who are already affected by other medical conditions. Tolerance to the chemotherapy sessions is a positive influencing factor
• Nevertheless, R-CHOP is considered a gold standard technique and a proven treatment method for individuals with DLBCL
• Chances of a relapse after 2 years are generally low. If after 5 years, there is no recurrence of the condition, then the outlook is very good and it is termed as a cure

Additional and Relevant Useful Information for Diffuse Large B-Cell Lymphoma:

• Treatment for Diffuse Large B-Cell Lymphoma can cause physical and emotional distress; supportive care and encouragement, help positively and can bring a measure of relief to the patients

The following article link will help you understand leukemia and lymphoma (blood cancer):

http://www.dovemed.com/diseases-conditions/leukemia-and-lymphoma/