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Diffuse large B cell lymphoma

 

 
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Diffuse large B-cell lymphoma (DLBL or DLBCL) is a type of aggressive lymphoma
Lymphoma

Lymphoma is a type of cancer that originates in lymphocytes of the immune system. They often originate in lymph nodes, presenting as an enlargement of the node ....
. It accounts for approximately 40% of lymphomas among adults. Of all cancers involving the same class of blood cell
Lymphoproliferative disorders

Lymphoproliferative disorders refer to several conditions in which lymphocytes are produced in excessive quantities. They typically occur in patients who have compromised immune systems....
, 31% of cases are DLBL.








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Diffuse large B-cell lymphoma (DLBL or DLBCL) is a type of aggressive lymphoma
Lymphoma

Lymphoma is a type of cancer that originates in lymphocytes of the immune system. They often originate in lymph nodes, presenting as an enlargement of the node ....
. It accounts for approximately 40% of lymphomas among adults. Of all cancers involving the same class of blood cell
Lymphoproliferative disorders

Lymphoproliferative disorders refer to several conditions in which lymphocytes are produced in excessive quantities. They typically occur in patients who have compromised immune systems....
, 31% of cases are DLBL.

Classification

Two or three major subtypes of DLBL have been identified based on their genetic activity:

  • activated (ABC-DLBCL), with a pattern of genetic expression that is similar to healthy, activated B cells, and
  • germinal center (GCB-DLBCL), with a pattern of genetic expression that is similar to germinal center
    Germinal center

    Germinal centres are areas within lymph nodes where B lymphocytes rapidly divide, and are an important part of the humoral immunity. They develop dynamically after the activation of B-cells by T-dependent antigen....
     B cells and a chromosomal translocation
    Chromosomal translocation

    In genetics, a chromosome translocation is a chromosome abnormality caused by rearrangement of parts between nonhomologous chromosomes. A fusion gene may be created when the translocation joins two otherwise separated genes, an event which is common in cancer....
     involving the gene bcl-2. This type has a relatively favorable prognosis.
  • primary mediastinal B-cell lymphoma (PMBL)


Chromosome anomalies are:
  • t(14;18)(q32;q21) with BCL2-rearrangement.
  • t(3;Var)(q27;Var) with BCL6
    BCL6

    B-cell CLL/lymphoma 6 , also known as BCL6, is a human gene....
    -rearrangement. These are common translocations.
  • t(8;14)(q24;q32) with MYC
    Myc

    Myc codes for a protein that binds to the DNA of other genes. When Myc is mutated, or overexpressed, the protein doesn't bind correctly, and often causes cancer....
     rearrangements.
  • and other less characteristic anomalies.


Treatment

Standard treatment is CHOP
Chop

Chop can refer to:* CHOP, a chemotherapy treatment for non-Hodgkin's lymphoma* Meat chop, a cut of meat usually containing a rib and served as an individual portion....
. An expanded protocol, called CHOP-R, has improved survival and rates of complete responses for DLBL patients, particularly elderly patients.

Prognosis

The germinal center subtype has the best prognosis, with 60% of treated patients surviving more than five years.