What Is Diffuse Large B-Cell Lymphoma?

Melissa Barrett

Diffuse large b-cell lymphoma (DLBCL) is a type of cancer that affects the white blood cells, lymph nodes, and other parts of the lymphatic system. DLBCL primarily affects white blood cells that are produced in the bone. These cells, called b-type lymphocytes, grow larger than normal and reproduce at faster rates. These cells, unlike most other cancerous cells, do not generally adhere to one another. As a result, they are scattered, or diffused, throughout the affected areas of a patient's lymphatic system.

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There is no known individual cause for diffuse large b-cell lymphoma, but several factors have been shown to increase the likelihood of developing the disease. Individuals with repeated exposure to certain herbicides or those who have a history of immunosuppressant use seem to be at higher risk. Patients who have health conditions that affect the immune systems are also more likely to develop DLBCL.

Often, diffuse large b-cell lymphoma stems from cancer in other parts of the body. When it exists independently, the most common symptoms of the disease include weight loss, fever, and night sweats. Occasionally, lymph nodes in the neck, underarms, and groin may become larger or develop growths. These growths are generally painless.

Preliminary diagnosis of diffuse large b-cell lymphoma is often accomplished by blood testing. The presence of lactose dehydrogenase (LDH), a chemical that is produced by damaged tissues, in the blood in addition to abnormal blood cell counts usually implicates further testing. Biopsies of suspected lymph glands or, more rarely, bone marrow biopsies are generally used to confirm the diagnosis.

The primary treatment for diffuse large b-cell lymphoma is chemotherapy. A combination of the drugs doxorubicin, rituximab, cyclophosphamide, and vincristine is given during each session. Often, the patient then takes a course of prednisone. This process is usually repeated several times. The patient is given a rest period between these treatments to recover.

Cancerous lymphocytes that are damaged by radiation are unable to repair themselves or multiply, so radiation therapy may also be useful in patients with DLBCL. The diffuse nature of DLBCL makes surgical intervention largely ineffective. Rarely, however, surgery may be necessary to remove or repair areas that have been damaged by the disease.

The chances of recovery from diffuse large b-cell lymphoma are generally fair when the cancer is discovered in stage one or two. The aggressive nature of the disease, however, makes survival from its later stages less likely. Elderly patients and those individuals who are in generally poor health are also less likely to recover. In cases when the cancer has spread to other parts of the body or when extensive tissue damage is detected, the prognosis is also poor.

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