Diffuse large B-cell lymphoma (DLBCL) is a fast-growing blood cancer that affects your lymphatic system. Healthcare providers typically treat it with a combination of cancer drugs. The combined drugs often eliminate DLBCL signs and symptoms. Medical researchers are studying different treatments for DLBCL that comes back.
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Diffuse large B-cell lymphoma, or DLBCL, is a blood cancer that involves changes in your B cells, a particular type of white blood cell (lymphocyte). It’s the most common form of aggressive non-Hodgkin lymphoma and a type of B-cell lymphoma.
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DLBCL affects your lymphatic system. Your lymphatic system is a network of tissues, vessels and organs that help fight infection in your body. Normal B cells are a part of that infection-fighting network. But with DLBCL, healthy B cells change into fast-growing cancer cells that overtake healthy ones. They’re no longer able to fight off infection-causing invaders, like viruses and bacteria.
With diffuse large B-cell lymphoma, cancerous B cells may appear in your lymph nodes. But they may also appear in virtually any organ, including your gastrointestinal tract, thyroid, skin, breast, bone or brain.
Although it’s aggressive, DLBCL is often treatable and curable — especially with early diagnosis and treatment.
The World Health Organization (WHO) has identified over a dozen different types of DLBCL. Each type’s unique traits tell healthcare providers how the cancer will likely progress and respond to treatment. The classifications depend on things like:
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Understanding how the specific type of diffuse large B-cell lymphoma will impact your care journey is important, but the specifics can be confusing. Ask your provider to explain how your type of DLBCL will impact treatment options and outlook.
Diffuse large B-cell lymphoma is the most common type of lymphoma. But as cancer diagnoses go, it’s still uncommon overall. According to the National Cancer Institute, in 2020, about 6 people in 100,000 received a DLBCL diagnosis. In comparison, about 500 people in 100,000 received a diagnosis of cancer affecting any part of their bodies.
The symptoms most people notice with diffuse large B-cell lymphoma are swollen lymph nodes in their neck, armpits or groin. They usually appear as a lump that doesn’t go away and seems to be getting larger. The lump isn’t usually painful, but it can be.
About 30%of people with DLBCL have “B symptoms,” which include:
Having these symptoms doesn’t necessarily mean you have diffuse large B-cell lymphoma. That said, you should contact a healthcare provider anytime you notice changes in your body that last for several weeks.
Diffuse large B-cell lymphoma happens when B cells mutate (change). These are acquired genetic mutations, meaning you develop them during your lifetime instead of being born with them.
Medical researchers aren’t sure what triggers the mutations in DLBCL, but they’ve identified several factors that may increase your risk. Risk factors for diffuse large B-cell lymphoma include:
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Healthcare providers diagnose DLBCL with a lymph node biopsy. This procedure removes all or part of a lymph node to check it for cancer cells. They also do genetic testing to learn which cell mutations are involved.
If you do have DLBCL, your provider may order additional tests to learn more about it, including whether it’s spread beyond your primary lymph node. Tests include:
Healthcare providers use cancer staging systems to determine how advanced the cancer is. This helps them develop treatment plans and estimate prognosis, or expected outcome. The stages of DLBCL are:
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Your provider may refer to stage I and II DLBCL as “early stage” and stage III and IV DLBCL as “advanced stage.”
One of the most common treatments for diffuse large B-cell lymphoma is R-CHOP. It combines the monoclonal antibody drug rituximab with three chemotherapy drugs and a corticosteroid.
This treatment is safe and effective but doesn’t always work or keep DLBCL from coming back (recurring). Studies show relapses or recurrent cancer affect an estimated 30% to 40% of people with DLBCL who receive R-CHOP. If that happens, your provider may recommend the following treatments:
There’s no guaranteed way to prevent DLBCL and nothing you can do about risk factors you can’t control, like having an immunodeficiency. But you can take steps to reduce your risk of developing certain infections linked to DLBCL, like hepatitis and HIV. You can also work to maintain a BMI (body mass index) that’s healthy for you.
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While some DLBCL can be life-threatening and difficult to treat, healthcare providers can often cure it using a combination of cancer drugs. Often, front-line or initial treatment sends DLBCL into complete remission. This means there are no signs and symptoms of cancer. Front-line treatment cures about 60% of people with DLBCL. In general, people who are cancer-free two years after their diagnosis can expect to live as long as most people in their age group.
According to the National Cancer Institute, 64.7% of all people with DLBCL are alive five years after diagnosis. Like many kinds of cancer, survival rates increase for people with early-stage cancer.
Still, while cure rates and survival rates may be helpful, your experience depends on many factors, including the type of DLBCL, cancer stage and your overall health. These are factors that only your healthcare provider knows about. Your provider is your best resource for answering questions about what to expect.
It can be stressful and exhausting to live with any form of cancer, including diffuse large B-cell lymphoma. It’s important that you do what you can to take care of yourself throughout DLBCL treatment. Here are some suggestions:
You’ll see your healthcare provider throughout your treatment. They’ll monitor your health and check how the treatment is working.
Afterward, you may see your provider every three to four months for the first two years and then less frequently for the next three years. That’s because diffuse large B-cell lymphoma may come back. Contact your healthcare provider if you notice changes in your body that may mean the cancer has recurred.
Cancer treatments for DLBCL, including chemotherapy and immunotherapy, may have strong side effects. Your healthcare provider will advise you on how to manage them and prescribe medications to help as needed. Still, you should go to the emergency room if you have:
Questions you may want to ask include:
When most of us hear the word “aggressive” used to describe cancer, we imagine a disease with a poor chance of survival. But things aren’t as straightforward with diffuse large B-cell lymphoma. While DLBCL spreads fast and can be life-threatening, current cancer treatments are usually effective at destroying the cancerous B cells. Healthcare providers even use words like “cure” to describe potential outcomes for some people.
Ask your healthcare provider how your diagnosis affects your treatment outlook. They can explain how your current health and the type and stage of cancer will likely impact what happens next. They can also connect you with resources to help support you through this diagnosis.
Last reviewed on 01/06/2025.
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