Patient education: Diffuse large B cell lymphoma (The Basics)

What is diffuse large B cell lymphoma? — Diffuse large B cell lymphoma, or "DLBCL," is a 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. It 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 1 or more swollen lymph nodes. These swollen nodes are often in the neck, groin, or belly. They can sometimes be felt under the skin, but they are usually not painful.

People with DLBCL can also have:

●Fever

●Weight loss

●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. They will also do:

●Blood tests

●Lymph node biopsy – A doctor removes 1 of the swollen lymph nodes. It is then looked at 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 bones) is 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.

●"Immunotherapy" – These are medicines that kill cancer cells by attacking the lymphoma cells.

●Radiation therapy – Radiation kills cancer cells.

All people with DLBCL get chemotherapy and immunotherapy. Some people also get radiation therapy.

What happens after treatment? — Your doctor will check to see if your DLBCL is gone. They will talk with you, do an exam, and order blood tests. They might also order an imaging test.

If your doctor does not see cancer in your blood or body, they 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 these symptoms, because it 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 your bone marrow that are killed by chemotherapy or radiation. It is also called a "stem cell transplant."

What else should I do? — Follow all of 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?

More on this topic

Patient education: Lymphoma (The Basics)
Patient education: Autologous bone marrow transplant (The Basics)
Patient education: Allogeneic bone marrow transplant (The Basics)
Patient education: Chemotherapy (The Basics)
Patient education: Bone marrow aspiration and biopsy (The Basics)

Patient education: Diffuse large B cell lymphoma in adults (Beyond the Basics)
Patient education: Hematopoietic cell transplantation (bone marrow transplantation) (Beyond the Basics)