Diffuse Large B-Cell Lymphoma (DLBCL)

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Diffuse Large B-Cell Lymphoma (DLBCL)?

Diffuse Large B-Cell Lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma from B-cells, the most common subtype (30-40% of NHLs), with ~25,000 US cases annually in 2025. It’s heterogeneous, with subtypes like germinal center B-cell-like (GCB, better prognosis) and activated B-cell-like (ABC). It can be primary or transformed from indolent lymphomas, often extranodal (GI, CNS).

Symptoms

Symptoms include rapidly enlarging painless lymph nodes (neck, groin, abdomen), B symptoms (fever >38°C, night sweats, weight loss >10%), fatigue, abdominal pain/swelling, and site-specific issues (e.g., bowel obstruction, neurological symptoms in CNS DLBCL). Symptoms progress quickly, over weeks.

Causes

Causes involve genetic mutations (MYC, BCL2, BCL6 rearrangements in 20-30%), EBV in immunocompromised, and chronic inflammation (e.g., hepatitis C). Risk factors include age (>60), immunosuppression (HIV, transplants), autoimmune diseases, and family history. In 2025, double-hit (MYC+BCL2) subtypes are aggressive.

Diagnosis

Diagnosis uses biopsy with immunohistochemistry (CD20+, CD79a+), FISH for rearrangements, and PET-CT for staging (Lugano criteria). Molecular testing classifies GCB/ABC. In 2025, NGS identifies mutations for targeted therapy.

Treatment

Standard is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), achieving 60-70% cure in early-stage. Advanced uses CAR-T (axicabtagene ciloleucel) for relapsed, with 40% remission. Targeted therapies (polatuzumab vedotin) replace vincristine. In 2025, bispecifics (glofitamab) show 50% response.

Future Outlook

In 2025, 5-year survival is 60-70%, 90% early-stage. CAR-T and bispecifics improve relapsed outcomes to 50%. By 2030, precision therapies could achieve 80% survival.

Sources

The information for DLBCL is drawn from Mayo Clinic’s “Diffuse large B-cell lymphoma – Symptoms and causes” for symptoms; Cleveland Clinic’s “Diffuse Large B-Cell Lymphoma (DLBCL)” for understanding; Lymphoma Action’s “diffuse large B-cell lymphoma (DLBCL)” for overview; PMC’s “Diffuse large B-cell lymphoma (DLBCL): Early Patient” for prognosis; Healthline’s “Diffuse Large B-Cell Lymphoma (DLBCL)” for symptoms; Blood Cancer UK’s “Prognosis for diffuse large B-cell lymphoma (DLBCL)” for outlook; Lymphoma Action’s PDF for treatment; My Lymphoma Team’s “Diffuse Large B-Cell Lymphoma: Symptoms, Diagnosis, Causes” for causes; Lymphoma.org’s “Diffuse Large B-Cell Lymphoma” for treatment; NCCN’s “NCCN Guidelines for Patients: Diffuse Large B-Cell Lymphomas” for guidelines.