T-cell lymphoma and B-cell lymphoma are two types of non-Hodgkin’s lymphoma. There’s also a rare type called NK-cell lymphoma.
Among people with non-Hodgkin lymphoma, about 85 percent have B-cell lymphoma.
Treatment for B-cell lymphomas is based on the specific subtype and stage of disease.
What are the subtypes of B-cell lymphoma?
There are many subtypes of B-cell lymphoma, both slow growing (indolent) and fast growing (aggressive), including:
|Diffuse large B-cell lymphoma (DLBCL)||This is the most common type of non-Hodgkin’s lymphoma. It’s an aggressive but treatable cancer that can involve lymph nodes and other organs.|
|Follicular lymphoma||This is the second most common type on non-Hodgkin’s lymphoma. It’s slow growing and usually starts in the lymph nodes.|
|Mantel cell lymphoma||Generally involves lymph nodes, bone marrow, spleen, and the gastrointestinal system.|
|Chronic lymphocytic leukemia (CLL)/Small lymphocytic lymphoma (SLL)||This type is indolent and typically affects the blood and bone marrow (CLL), or lymph nodes and spleen (SLL).|
|Primary central nervous system lymphoma||This type usually starts in the brain or spinal cord. It’s associated with immune problems caused by AIDS or anti-rejection medications used following organ transplantation.|
|Splenic marginal zone B-cell lymphoma||This is a slow-growing type that begins in the spleen and bone marrow.|
|Extranodal marginal zone B-cell lymphoma of MALT||This type usually involves the stomach. It can also occur in the lungs, skin, thyroid, salivary gland, or eye.|
|Nodal marginal zone B-cell lymphoma||This is a rare, slow-growing type found mainly in the lymph nodes.|
|Burkitt lymphoma||This is a fast-growing type that is more common in children.|
|Hairy cell leukemia||This is a slow-growing type that affects the spleen, lymph nodes, and blood.|
|Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia)||This is a rare, a slow-growing lymphoma of the bone marrow, spleen, and lymph nodes.|
|Primary effusion lymphoma||This is a rare, aggressive type that tends to occur in people who have a weakened immune system.|
Cancer is staged according to how far it has spread from the original site. Non-Hodgkin’s lymphoma is staged from 1 to 4, with 4 being the most advanced.
What are the symptoms?
Symptoms vary according to the type of B-cell lymphoma and how advanced it is. These are some of the main symptoms:
- swollen lymph nodes in your neck, armpits, or groin
- abdominal pain or swelling
- chest pain
- breathing difficulties
- fever and night sweats
- weight loss
How is it treated?
Certain types of lymphoma that are asymptomatic and indolent don’t necessarily require treatment. Your doctor may recommend what is known as “watchful waiting.” That means you’ll follow up every few months to make sure the cancer isn’t advancing. In some cases, this can continue for years.
Treatment can start when symptoms appear or if there are signs of disease progression. B-cell lymphoma often involves a combination of treatments, which may change over time.
Using high-powered energy beams, radiation therapy is used to kill cancer cells and shrink tumors. It requires lying very still on a table while the beams are directed to a precise point on your body.
For slow-growing, localized lymphoma, radiation therapy may be all you need.
Side effects can include fatigue and skin irritation.
Chemotherapy is a systemic treatment that can be given orally or intravenously. Some aggressive B-cell lymphomas can be cured with chemotherapy, especially in early stage disease.
DLBCL is a fast-growing type that can be treated with a chemotherapy regimen called CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone). When given along with the monoclonal antibody rituximab (Rituxan), it’s called R-CHOP. It’s usually given in cycles several weeks apart. It’s hard on the heart, so it’s not an option if you have preexisting heart problems.
Side effects of chemotherapy may include nausea, fatigue, and hair loss.
Biologic drugs help your immune system fight cancer. Rituximab targets proteins on the surface of B-cells, making it easier for the immune system to identify and destroy them. By decreasing the number of cancerous and healthy B-cells, the drug prompts your body to produce new healthy B-cells. This makes it less likely that cancer will recur.
Radioimmunotherapy medicines, such as ibritumomab tiuxetan (Zevalin), are made of monoclonal antibodies that carry radioactive isotopes. The drug helps antibodies attach to the cancer cells for direct delivery of radiation.
Side effects of immune therapy can include low white blood cell counts, fatigue, and infections.
Stem cell transplant
A stem cell transplant involves replacing your bone marrow with marrow from a healthy donor. First, you’ll need high-dose chemotherapy or radiation to suppress your immune system, destroy cancer cells, and make room for the new marrow. To be eligible, you must be healthy enough to withstand this treatment.
Side effects can include infections, anemia, and rejection of the new bone marrow.
Are there possible complications?
Lymphomas weaken your immune system, making you more vulnerable to infections. Some treatments for lymphoma can cause complications such as:
B-cell lymphomas can grow and spread to distant organs.
What’s recovery like?
Some types of B-cell lymphomas can be cured. Treatment can slow progression in others. If there’s no sign of cancer after your primary treatment, it means you’re in remission. You’ll still need to follow up for several years to monitor for recurrence.
The overall five-year relative survival rate for non-Hodgkin’s lymphoma is 70 percent. This varies a lot according to the type of B-cell lymphoma and stage at diagnosis. Other considerations are your age and overall health.
For example, DLBCL is curable in about half of people who have it. Those who start treatment in earlier stages have a better outlook than those who have later-stage disease.
Your doctor can provide you with your personal prognosis based on your complete health profile.