b cell lymphoma symptoms | Diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma

Diffuse Lymphoma large cell B (DLBCL) is the most common type of lymphoma non Hodgkin (NHL). When observed under a microscope, lymphoma cells seem very large compared to normal lymphocytes. The lymphoma cells are also scattered in all the lymph and lymph tissues.

DLBCL can occur in people of any age, but most are diagnosed while they reached the sixties. It affects slightly more often human.

In general, DLBCL originates in the lymph nodes, but it can also do in organs or tissues which lie outside the lymph nodes (primitive extranodal disease) and locations the most common include the following:

OS
brain or spinal cord (central nervous system, or CNS)
digestive tract (GI tract)
Sinus
testicles
thyroid gland
skin
In 30 to 40% of cases, DLBCL is localized (stage 1 or 2) when it is diagnosed. Others are widespread at the time of diagnosis, which means that DLBCL has spread to the lymph nodes located above and below the diaphragm or different parts of the body, such as the spleen, liver or bone marrow.

The rare DLBCL subtypes include:
primitive mediastinal large B cell lymphoma
primitive Lymphoma of PEL (LPS)
intravascular large B-cell lymphoma
DLBCL is a type of NHL rapidly evolving (aggressive). Some types of lymphoma B slowly-moving (indolent) can turn into DLBCL. These include these:

Follicular Lymphoma
MALT Lymphoma
splenic marginal zone Lymphoma
small cell lymphoma
Lymphoma lymphoplasmocytaire
Symptoms
In the case of DLBCL, lymph nodes become larger than normal, that's why you can feel to the touch. B symptoms, such as unexplained fever, important night sweats and unexplained weight loss can also occur.

Treatments
DLBCL is very sensitive to chemotherapy, so it is used as the main treatment. Although DLBCL is a type of NHL which is changing rapidly, chemotherapy is effective for many people. It is possible that DLBCL reappears (recurrence) after that it has administered the first sessions of treatment.

Chemotherapy
Is used with chemotherapy to treat all stages of DLBCL. The chemotherapy combination most often administered as initial treatment of DLBCL is called CHOP and is composed of:

Cyclophosphamide (cytoxan, procytox)
Doxorubicin (adriamycin)
Vincristine (oncovin)
Prednisone
Usually given chemotherapy with a targeted drug. Protocol R-CHOP, or CHOP chemotherapy association and rituximab (Rituxan) is called.

If DLBCL reappears after being treated, or does not respond to the treatment, you will administer the following chemotherapeutic agents:

R - GDP - gemcitabine (Gemzar), dexamethasone (Decadron, Dexasone), cisplatin (Platinol AQ) and rituximab

R - DHAP - dexamethasone, cytarabine (Cytosar, Ara - C), cisplatin and rituximab

cytarabine

bendamustine (Treanda)

PEPC - prednisone, etoposide (Vepesid, VP-16), cyclophosphamide and procarbazine (Natulan)

R - ICE - ifosfamide (Ifex), carboplatin (Paraplatin, Paraplatin-AQ), etoposide and rituximab

Targeted treatment

Targeted therapy is medication used to target specific molecules (and proteins) located on the surface of cancer cells. These molecules contribute to sending signals that tell cells to grow or divide. By targeting these molecules, drugs interrupt the growth and spread of cancer cells while minimizing damage to normal cells.

Rituximab is a targeted drug frequently given alone or in combination with chemotherapy to treat DLBCL.

Radiotherapy

We can administer external radiotherapy after chemotherapy to treat stage 1, and sometimes stage 2 DLBCL. When DLBCL appears in one testicle, it is possible that radiation therapy to the other testicle also in order to prevent the spread of lymphoma cells.

Sometimes, that radiation therapy after chemotherapy in dlbcl of more advanced stage. It is used if the disease is still present on a small surface or tumors measuring less than 10 cm in diameter are present in other regions (bulky disease).

The central nervous system prophylaxis

The central nervous system (CNS) is made of the brain and the spinal cord. DLBCL which originates in the sinus or testicles may spread to the SNC. CNS prophylaxis is to try to prevent the lymphoma cells from spreading to the brain and the spinal cord.

It is possible that given prophylaxis of the CNS by intrathecal chemotherapy, which means that the chemotherapeutic agent is injected directly into the cerebrospinal fluid (CSF). The drug used is methotrexate.

You can also administer the prophylaxis of the SNC using a needle inserted into a vein (intravenous). The drug used is high-dose methotrexate.

Stem cell transplant

We can provide other treatment options including DLBCL does not disappear after treatment or recurs after treatment (recurrence). These treatments may include other types of chemotherapy and a stem cell transplant. Stem cell transplant may be an option if DLBCL has already responded to chemotherapy before.