B-cell Lymphoma

Overview

What is B-cell lymphoma?

B-cell lymphoma refers to a group of cancers that affect your immune system. B-cell lymphoma makes up 85% of all non-Hodgkin lymphomas, which are among the most common cancers in the United States.

B-cell lymphoma frequently affects your lymphatic system, which is a network of lymph nodes, lymph vessels and tissues that move fluid around your body. Lymph is one of the fluids your lymphatic system carries through your body. Lymph contains white blood cells called lymphocytes. B-cells, or B-lymphocytes, make antibodies that fight infection. Normally, healthy B-cells die to make room for more B-cells.

B-cell lymphoma happens when healthy B-cells change into fast-growing cancer cells that don’t die. The cancer cells duplicate, eventually overwhelming healthy cells. The cancer cells can also spread to other areas of your body including the bone marrow, spleen or other organs.

B-cell lymphoma survival rates continue to improve as researchers identify more effective treatments. Approximately 65% of people diagnosed with the most common form of B-cell lymphoma are alive five years after diagnosis and considered cured.

What are the most common B-cell lymphoma types?

There are more than 70 types of B-cell lymphoma. Here are the most common:

  • Diffuse large B-cell lymphoma. This is the most common type of B-cell lymphoma. It accounts for 1 in 3 lymphomas. It usually appears in your lymph nodes. Each year, approximately 6 people in 100,000 are diagnosed with diffuse large B-cell lymphoma. Most information about non-Hodgkin’s lymphoma comes from what we know about diffuse large B-cell lymphoma.
  • Follicular lymphoma. This is a slow-growing B-cell lymphoma that may appear in your lymph nodes and/or your bone marrow and other organs.
  • Chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). This is a slow-growing B-cell lymphoma that develops in your blood and bone marrow. CLL/SLL may appear in your lymph nodes and spleen.
  • Mantle cell lymphoma. This lymphoma is usually found in your lymph nodes, bone marrow and spleen.
  • Marginal zone lymphomas. This is a slow-growing lymphoma. Some forms of marginal zone lymphomas are found in your stomach, lungs, skin, thyroid, salivary glands and tissues around your eyes.
  • Burkitt lymphoma. This is a fast-growing lymphoma that’s usually found in your stomach.
  • Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia or WM). This is a rare, slow-growing lymphoma that develops in your liver and spleen. This lymphoma produces an antibody or immunoglobulin called M-protein that may cause other symptoms.

Who is affected by B-cell lymphoma?

People between ages 65 to 74 represent more than 25% of all diffuse large B-cell lymphoma cases, the most common type of B-cell lymphoma. More men than women develop diffuse large B-cell lymphoma, with Hispanic men representing the largest ethnic/racial group affected by B-cell lymphoma.

Symptoms and Causes

What are B-cell lymphoma symptoms?

B-cell lymphoma has many symptoms, and many of the symptoms below may be related to other conditions. Symptoms that may be related to B-cell lymphoma include:

  • Fever.
  • Drenching night sweats.
  • Unintentional loss of more than 10% of body weight over 6 months.
  • Painless swelling in one or more lymph node(s).
  • Persistent fatigue.
  • Loss of appetite.
  • Cough or chest pain.
  • Stomach pain.
  • A sensation of bloating or fullness caused by an enlarged spleen.
  • Itchy skin.
  • Enlargement of the spleen or liver.
  • Rashes or skin lumps.

What causes B-cell lymphoma?

Sometimes random events that can’t be traced to a specific cause will transform B-cells from healthy, infection-fighting white blood cells into cancer cells. But researchers have turned up connections between the following conditions and/or activities:

Can being exposed to certain chemicals cause B-cell lymphoma?

Some research indicates people who have prolonged and extensive exposure to certain herbicides used in agriculture may have a slightly increased risk of developing lymphoma. That being said, it’s not likely that lymphoma is caused by infrequent or occasional herbicide exposure.

Diagnosis and Tests

How is B-cell lymphoma diagnosed?

Healthcare providers use a range of tests to diagnose B-cell lymphoma:

  • Complete blood count (CBC). A CBC measures and counts your blood cells. Providers use CBC to detect a variety of illnesses.
  • Blood chemistry test. This test measures the number of certain substances in your blood.
  • Computed tomography (CT) scan. CT scans use a series of X-rays and a computer to create three-dimensional images of your soft tissues and bones.
  • Positron emissions tomography (PET) scan. Providers inject a radioactive tracer into your body to detect early signs of cancer.
  • Magnetic resonance imaging (MRI). This is a painless test that uses a large magnet, radio waves and a computer to produce very clear images of organs and structures within your body.
  • Lumbar puncture (spinal tap). To do this test, your healthcare provider inserts a needle into your lower back to get a sample of cerebrospinal fluid, the clear liquid that surrounds your spine and brain.
  • Bone marrow biopsy. To do this test, providers insert a special needle through your skin and into your pelvic bone or breastbone so they can remove a small sample of bone marrow from inside it.

Management and Treatment

What treatments are there for B-cell lymphoma?

B-cell lymphoma treatment options typically include the following:

  • Chemotherapy. Healthcare providers use several types of drugs to kill cancer cells.
  • Radiation therapy. Healthcare providers use strong beams of energy (radiation) to kill cancer cells or stop them from growing.
  • Targeted therapy. This treatment involves medications that target specific changes in cancer cells.
  • Immunotherapy. This cancer treatment uses your immune system to fight cancer by helping your body produce cancer-fighting cells or help healthy cells identify and attack cancer cells.
  • Stem cell transplantation. A stem cell transplant replaces unhealthy stem cells with healthy stem cells.

What are the side effects of B-cell lymphoma treatment?

Each B-cell lymphoma treatment has different side effects. And people often react differently to any given treatment. Talk to your healthcare provider about each treatment option and potential side effects. Understanding how your treatment might affect you can help you feel more confident about managing side effects.

Prevention

How can I reduce my risk of developing B-cell lymphoma?

Unfortunately, there is no proven strategy to reduce your risk for developing lymphoma. Talk to your healthcare provider about your medical history and your concerns that you might be at risk for B-cell lymphoma.

Outlook / Prognosis

Is B-cell lymphoma curable?

There are many ways to treat B-cell lymphoma and survival rates continue to improve as researchers find more effective treatments.

Living With

How do I take care of myself?

Treatment for B-cell lymphoma can include chemotherapy, radiation therapy and newer treatments such as targeted therapies, immunotherapies and CAR T-cell therapy. Understanding how to manage treatment side effects is an important part of self-care. In addition, there are other things you can do to take care of yourself:

  • Have a plan for living with cancer. That plan might be lining up support during treatment, whether that’s arranging for special meals, transportation to appointments or someone to keep you company during treatment.
  • Cancer is stressful. You might find activities such as meditation, relaxation exercises or deep breathing exercises help to ease your stress.
  • Find ways to incorporate regular physical activity into your day.
  • Reach out for support from others who've been in your situation. Your healthcare provider can direct you to support groups and programs where you can express your feelings and concerns with people who understand what you're going through.
  • Chemotherapy treatments might affect your appetite. Try to eat a healthy diet, and talk to a nutritionist if you're having trouble eating.
  • Radiation treatment can leave you feeling exhausted. Plan to rest as much as possible during your treatment.

When should I see my healthcare provider?

Ask your healthcare provider if there are physical changes you should look for as you go through treatment or physical changes that might indicate your cancer is progressing. Let your provider know any time you have questions or concerns. You should also contact them any time you have unexpected or unusual side effects from treatment or changes in your body.

When should I go to the emergency room?

Many cancer treatments affect your immune system, increasing the chance you'll develop infections. You may also have unusually strong side effects from your cancer treatment. While your healthcare provider likely gave you medication to help control your side effects, you should go to the emergency room if your side effects continue despite medication. Symptoms that might require an emergency room visit are:

  • Fever of 100.4 ֯ Fahrenheit (38.3 ֯ Celsius) and above.
  • Chills.
  • Productive or "wet" cough.
  • Stomach pain.
  • Persistent diarrhea.

What questions should I ask my healthcare provider?

A diagnosis of B-cell lymphoma encompasses a lot of different cancer sub-types. Understanding your specific diagnosis will help you feel confident about your choices and help you create a plan for living with cancer. Here are some questions to consider:

  • What is B-cell lymphoma?
  • What kind of B-cell lymphoma do I have?
  • Where is my cancer located?
  • Has my cancer spread?
  • What are my options for treatment?
  • Why do you recommend that treatment?
  • What are the side effects for each treatment?
  • What is the prognosis for that cancer?

A note from Cleveland Clinic

B-cell lymphoma symptoms can look and feel just like many less serious illnesses, so it can be a shock when your seemingly simple health issue turns out to be cancer. You might need some time to work through your emotions. When you’re ready, your healthcare providers will be there to help you understand your diagnosis and your treatment options. Understanding your illness can help you feel more confident about your next steps.

Last reviewed by a Cleveland Clinic medical professional on 11/02/2021.

References

  • American Cancer Society. Survival Rates and Factors That Affect Prognosis (Outlook) For Non-Hodgkin Lymphoma. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738913/) Accessed 11/2/2021.
  • American Cancer Society. Types of B-Cell Lymphoma. (https://www.cancer.org/cancer/non-hodgkin-lymphoma/about/b-cell-lymphoma.html) Accessed 11/2/2021.
  • American Society of Clinical Oncology. Lymphoma-Non Hodgkin; Subtypes. (https://www.cancer.net/cancer-types/lymphoma-non-hodgkin/subtypes) Accessed 11/2/2021.
  • Bassig BA, Lan Q, Rothman N, Zhang Y, Zheng T. Current Understanding of Lifestyle and Environmental Factors and Risk of Non-Hodgkin Lymphoma: An Epidemiological Update. (https://pubmed.ncbi.nlm.nih.gov/23008714/) J Cancer Epidemiol. 2012;2012:978930. Accessed 11/22021.
  • Cerhan JR, Slager SL. Familial predisposition and genetic risk factors for lymphoma. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643002/) Blood. 2015 Nov 12;126(20):2265–2273. Accessed 11/2/2021.
  • Cesarman E. How do viruses trick B cells into becoming lymphomas? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126608/) Curr Opin Hematol. 2014 Jul;21(4):358–368. (https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24886824) Accessed 11/2/2021.
  • Koff JL, Flowers CR. Prognostic Modeling In Diffuse Large B-Cell Lymphoma in the Era of Immunochemotherapy: Where Do We Go From Here? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738913/) Cancer. 2017 Sep 1; 123(17): 3222–3225. (https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28464215) Accessed 11/2/2021.
  • Leukemia & Lymphoma Society. Signs and Symptoms. (https://www.lls.org/lymphoma/non-hodgkin-lymphoma/signs-and-symptoms) Accessed 11/2/2021.
  • StatPearls. Non-Hodgkin Lymphoma. (https://www.ncbi.nlm.nih.gov/books/NBK559328/) Accessed 11/2/2021.
  • van de Schans SA, van Steenbergen LN, Coebergh JW, Janssen-Heijnen ML, van Spronsen DJ. Actual prognosis during follow-up of survivors of B-cell non-Hodgkin lymphoma in the Netherlands. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912965/) Haematologica. 2014 Feb;99(2):339–345. Accessed 11/2/2021.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy