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Blood cancer information Types of blood cancer Lymphoma Non-Hodgkin lymphoma
Diffuse large B-cell lymphoma


DIFFUSE LARGE B-CELL LYMPHOMA




WHAT IS DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL)?

Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of non-Hodgkin
lymphoma that develops from the B-cells in the lymphatic system. Under the
microscope, large malignant lymphocytes are seen diffusely throughout the
specimen.

DLBCL is the most common subtype of non-Hodgkin lymphoma accounting for 30%-40%
of all cases. There are several types of DLBCL, with most people being diagnosed
with the subtype known as DLBCL ‘not otherwise specified’. Rarer types include:

 * Primary mediastinal large B-cell lymphoma: accounts for 2-4% of all
   non-Hodgkin lymphomas. Can occur at any time from early adulthood, but is
   most common between 25-40 years of age. It is twice as common in women as in
   men. Develops in the mediastinum (in the chest) and can cause problems due to
   the pressure of the mass on the lungs or gut, or on the superior vena cava
   (the second largest vein in the body which returns blood from the upper half
   of the body to the heart).Symptoms include breathlessness, persistent cough,
   difficulty swallowing (dysphagia), swelling of the neck and face, dizziness
   and headaches. Treatment involves the use of a targeted therapy plus standard
   chemotherapy, often followed by radiotherapy or high-dose chemotherapy
   regimens. Stem cell transplants may be offered if this type of lymphoma
   relapses.
 * T-cell/histiocyte-rich large B-cell lymphoma: more common in men aged over 50
   years but can affect people of any age. Fewer than 10% of people with DLBCL
   will have this type. This type of DLBCL has all three types of cells present-
   T-cells, histiocytes and large B-cells, when viewing a biopsy specimen under
   the microscope. Symptoms include swollen lymph nodes, fever and swelling of
   the liver or spleen. People with this type of DLBCL will feel generally
   unwell and have abdominal swelling and discomfort. Treatment is similar to
   that of the more common types of DLBCL (such as a targeted therapy plus
   standard chemotherapy). If it relapses, the other high-dose chemotherapy
   regimens mentioned below may be used. Stem cell transplantation may also be
   an option for some people.
 * Intravascular large B-cell lymphoma: extremely rare form of lymphoma. Occurs
   in adults with the average age at diagnosis being 65 years. Malignant
   lymphocytes are found within small blood vessels meaning it could affect just
   about any part of the body, although it is rare to find it in the bone marrow
   or lymph nodes.Symptoms vary depending on which small blood vessels are
   affected, but 75% of people with this form of DLBCL experience stroke-like
   symptoms; for example, weakness, numbness or paralysis in the face, arm or
   legs on either or both sides of the body, difficulty speaking or
   understanding, dizziness, loss of balance or unexplained falls, changes in
   vision, severe headaches, and difficulty swallowing. These symptoms are a
   result of the impact of the lymphoma on the nervous system. Some people may
   also develop patches of inflamed skin across their body or experience fevers,
   night sweats and unexplained weight loss. Intravascular large B-cell lymphoma
   is often treated with a targeted therapy plus standard chemotherapy and/or
   more aggressive therapies if suitable for that particular person.


HOW DOES DIFFUSE LARGE B-CELL LYMPHOMA AFFECT THE BODY?

Often the first symptom of DLBCL is a painless swelling in the neck, armpit or
groin that is caused by enlarged lymph nodes. These lumps can grow quite
quickly, often over a period of a few weeks.  Sometimes, other parts of the body
are also affected. This is known as ‘extranodal’ disease because it is happening
outside of the lymph nodes, and includes the stomach or bowel being affected,
which may cause abdominal discomfort or pain, diarrhoea or bleeding. DLBCL can
also be found in many other areas including the salivary glands, nasal sinuses,
liver, lungs, testes, skin, brain or eye with symptoms being directly related to
the amount of pressure the lymphoma is putting on the particular body part that
is affected. Other general symptoms experienced by people with DLBCL include
fevers, night sweats and unexplained weight loss.


WHO DOES DIFFUSE LARGE B-CELL LYMPHOMA COMMONLY AFFECT?

DLBCL can occur at any age, but is most common in people aged over 50 years. The
average age of diagnosis is 60-65 years; however, DLBCL can also affect
children. It is slightly more common in men than in women. It is not due to
infection and cannot be passed from one person to another. DLBCL may develop
independently or in some instances may develop in people who have been diagnosed
with a low-grade lymphoma in the past (i.e. low-grade lymphoma can transform to
DLBCL).


WHAT CAUSES DIFFUSE LARGE B-CELL LYMPHOMA?

Whilst the exact causes of DLBCL are unknown, people who have a compromised
immune system may be more susceptible to developing DLBCL. This may include
people who have previously been treated for other forms of cancer including a
low-grade lymphoma, or people who have an autoimmune disorder.


HOW IS DIFFUSE LARGE B-CELL LYMPHOMA TREATED?

DLBCL is high-grade (fast-growing) and needs to be treated quickly. The current
treatment is a targeted therapy plus standard chemotherapy. This treatment
usually continues for approximately 4 months. Other therapies include radiation,
stem cell transplants and other chemotherapy. If the DLBCL relapses after
initial treatment, several chemotherapy regimens can be used. If the DLBCL has
infiltrated the cerebrospinal fluid, additional chemotherapy can be given
directly into the spinal cord. DLBCL is very responsive to treatment with a
large percentage of people being cured.


HOW WE CAN HELP

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Last updated on December 15, 2023

Developed by the Leukaemia Foundation in consultation with people living with a
blood cancer, Leukaemia Foundation support staff, haematology nursing staff
and/or Australian clinical haematologists. This content is provided for
information purposes only and we urge you to always seek advice from a
registered health care professional for diagnosis, treatment and answers to your
medical questions, including the suitability of a particular therapy, service,
product or treatment in your circumstances. The Leukaemia Foundation shall not
bear any liability for any person relying on the materials contained on this
website.

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BLOOD CANCER A – Z

 * Acute lymphoblastic leukaemia (ALL)
 * Acute myeloid leukemia (AML)
 * Acute promyelocytic leukaemia (APML)
 * Adult T-cell lymphoma (ATLL)
 * Anaplastic large cell lymphoma (ALCL)
 * Amyloidosis
 * Aplastic anaemia (AA)
 * Biphenotypic leukaemia
 * Burkitt’s lymphoma
 * Chronic lymphocytic leukaemia (CLL)
 * Chronic myeloid leukaemia (CML)
 * CNS lymphoma
 * Diffuse large B-cell lymphoma (DLBCL)
 * Double hit lymphoma (DHL)
 * Essential Thrombocythaemia (ET)
 * Follicular lymphoma (FL)
 * Hairy cell leukaemia (HCL)
 * Hodgkin lymphoma (HL)
 * Leukaemia / Leukemia
 * Lymphoblastic lymphoma (LL)
 * Lymphoma
 * MALT lymphoma
 * Mantle cell lymphoma (MCL)
 * Marginal zone lymphoma (MZL)
 * Monoclonal gammopathy of unknown significance (MGUS)
 * Myelodysplastic neoplasms (MDS)
 * Myelofibrosis (MF)
 * Myeloma
 * Myeloproliferative neoplasms (MPN)
 * Non-Hodgkin lymphoma (NHL)
 * Peripheral T-cell lymphoma (PTCL)
 * Polycythaemia (Rubra) vera (PRV)
 * Skin lymphomas
 * Small lymphocytic lymphoma (SLL)
 * Solitary plasmacytoma
 * Waldenstrom’s macroglobulinaemia (WM)

CURING AND CONQUERING
BLOOD CANCER



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