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Diffuse Large Cell Lymphoma |
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| Diffuse Large B-Cell Lymphoma (DLCL) is the one third 20% of non-Hodgkin's lymphomas. DLCL is the one type of NHL where the incidence does not vary geographically. There are several subtypes and variants of DLCL: | |||
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Subtypes
Adults - The median age of people at diagnosis is 57, with a range of 10-88 years, most often in people in their 70s. As aggressive malignancies with a tendency to metastasize, the majority eventually demonstrate some extranodal component, including the gastrointestinal tract, testes, thyroid, skin, breast, central nervous system or bone. Although generally extra-nodal involvement is more common than in follicular lymphomas, the marrow is involved only about 10% of the time. DLCL can arise from other types of lymphoma including small B-cell lymphoma, follicular lymphoma, or marginal zone lymphoma - this is called transformed diffuse large cell lymphoma. Armitage et al. state that DLCL that occurs in sites where MALT lymphomas are found are best labeled DLCL rather than a transformed lymphoma. Causes: There is strong evidence of a genetic factor in DLCL. 15% to 30% of the cases have a t(14;18), BCL-2 gene rearrangement. The c-MYC gene is rearranged in 5-15% of cases. The BCL6 gene is rearranged in 20-40% of cases and has some mutations in a noncoding region in 70% of cases. Children - Large cell lymphomas also one of the more common NHLs in children, accounting for about 20-25% of childhood lymphomas. Treatment Recent advances in tissue testing allow medical personnel to know the exact features of the lymphoma, allowing them to select the therapy that may work best given the lymphoma characteristics.
Combination chemotherapy containing adriamycin (such as CHOP) is often used in DLCL with or without follow-up radiation. Stem Cell transplants have been used when the above treatments have not been effective or for relapsed lymphoma. Use of monoclonal antibody therapy, using drugs such as rituxan have occurred in trials and use of these drugs with or without CHOP may be the upcoming standard in treatment. Further Reading / In-Depth
Web Resources:
Multimedia (in conjunction with Healthology)
Survivor Sites:
Reference Sources & Information
Non-Hodgkin's Lymphoma Information Pages: Non-Hodgkin's
Lymphomas Childhood Lymphoma Information Pages: Childhood
Lymphoma Home - Gateway to Support and More The Lymphoma Information Network This page is a work in progress - if you have more complete information, references, or other information please contact the author. The author is not in the medical field and does not warrant the correctness of the material on this page or the sites linked - please take online information and consult with your own medical team to make informed decisions. Copyright © 1998-2005 Lymphoma Information
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