Diffuse Large B-cell Lymphoma (DLBCL) Diagnosis and Treatment

What Type of Non-Hodgkin Lymphoma is DLBCL?

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Diffuse large B-cell lymphoma is the most common type of non-Hodgkin's lymphoma (NHL)  It is a lymphoma of B lymphocytes, or "B cells."

Aggressive Cancers

DLBCL's are aggressive cancers. They are sometimes referred to as "high grade" or "intermediate grade" lymphomas in contrast to "low grade" lymphomas which are slower growing.  This means that they can grow quickly and spread rapidly to other parts of the body.

This aggressive behavior can sound frightening until you consider how we treat cancers.  Treatments such as chemotherapy kill rapidly growing cells.  So in this age when we have treatments available, someone is often much more likely to be "cured" from a high grade lymphoma than from a lower grade lymphoma. Roughly 70% of people who are treated for DLBCL will be cured of their disease.


The B-cells in DLBCL are large, and look very different than ordinary B cells. When a lymph node is biopsied, these cells are present all over the lymph node - in a diffuse distribution which gives rise to its name.

Who Gets It

Diffuse large B-cell lymphoma mostly affects those above 50 years of age, though people of any age can get it. The average age at diagnosis is 64.  It is more common in men than in women. DLBCL, unlike some lymphomas, does not appear to run in families.


DLBCL is usually discovered when someone notes an enlarged, but non-tender lymph node in their neck or groin. Some people may have what are called the B symptoms of lymphoma which include fevers and drenching night sweats.

How Does DLBCL Affect the Body?

About 2/3 of those who have diffuse large B-cell lymphoma have advanced disease at the time of diagnosis, extending to different parts of the body. In nearly half of the patients, the disease affects parts of the body outside the lymph nodes, such as the stomach (called extranodal disease). The bone marrow is affected in about 10-20% of the patients.


The diagnosis of lymphoma is generally done with a lymph node biopsy. The disease is confirmed as a lymphoma, and the type of lymphoma is determined by looking at its cells under the microscope and special tests called CD markersNewly diagnosed patients have to undergo a series of tests to determine how far the disease affects the body.


Treatment depends on the stage of the lymphoma and may include:

Chemotherapy and monoclonal antibody therapy - Almost all patients receive chemotherapy. The most common regime is R-CHOP or CHOP for 6-8 cycles. The drugs in R-CHOP include:

  • Rituxan (rituximab) - Rituxan is a monoclonal antibody. Our bodies make antibodies that attack bacteria and viruses that enter our bodies. Rituxan is essentially a man-made antibody, which instead of attacking bacteria and viruses, attacks cancer cells instead.
  • Cytoxan (cyclophosphamide)
  • Adriamycin (doxorubicin)
  • Oncovin (vincristine)
  • Prednisone

Cycles are usually done every 3 weeks for a total of 8 cycles.

Radiation - Radiation therapy may be included as part of the treatment for those with early stages of DLBCL. Radiation in this case is usually delivered to the areas involved by the cancer.

Recurrent or Persistent DLBCL

The majority of people will be cured with aggressive chemotherapy. Those who are not cured or have a recurrence of their disease have options for further chemotherapy, antibody therapy and stem cell transplantation.


The prognosis of DLBCL depends on a number of factors including age and stage of disease. The factors are described in the section on prognostic factors of Non-Hodgkin Lymphoma (NHL).

Coping and Support

Even though DLBCL has a good prognosis - as far as lymphomas go anyway - it is terrifying to be diagnosed with cancer. Reach out to family and friends. Research and learn about your disease by finding credible information. Consider joining a support group in your community or check out the DLBCL support communities online. And keep in mind that treatments for cancer are continuously improving - both in treatments that improve survival rates, and in those which produce fewer side effects.

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Article Sources

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  • Freedman, A., and J. Friedberg. Patient information: Diffuse large B cell lymphoma in adults (Beyond the Basics), UpToDate. Updated 06/30/15. http://www.uptodate.com/contents/diffuse-large-b-cell-lymphoma-in-adults-beyond-the-basics