B-Cell Lymphoma

B-cell lymphoma is a group of blood cancers that can affect your lymphatic system. Your lymphatic system is a large network of organs, vessels and tissues. B-cell lymphoma can develop in many places in your body and cause different symptoms.

The condition starts in your B lymphocytes. These are white blood cells that fight infection. With B-cell lymphoma, abnormal B cells multiply to crowd out healthy cells. Most B-cell lymphoma types are a form of non-Hodgkin lymphoma.

Treatment can cure some types of this condition. It can also put some types into remission. This is when you don’t have symptoms and tests don’t find signs of cancer. But B-cell lymphoma can come back after treatment.

Types of B-cell lymphoma

This condition can spread very quickly (aggressive B-cell lymphoma) or grow more slowly (indolent B-cell lymphoma).

Aggressive B-cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive B-cell lymphoma. DLBCL has different forms. It may start in your lymph nodes or in different organs throughout your body.

Other aggressive condition types include:

• Burkitt lymphoma: This rare, fast-growing lymphoma may develop in your stomach and then spread to other organs.
• High-grade B-cell lymphoma (HGBCL): Like diffuse large B-cell lymphoma, this type typically starts in your lymph nodes. Treatment may put the condition into remission, but it often comes back.

Indolent B-cell lymphoma

Follicular lymphoma is the second most common type of B-cell lymphoma. You may develop it in your lymph nodes, bone marrow and other organs. Other types of indolent B-cell lymphoma include:

• Chronic lymphocytic leukemia (CLL): This condition is similar to small lymphocytic lymphoma (SLL). The difference is that CLL typically affects your blood and bone marrow. SLL typically affects your lymphatic system.
• Cutaneous B-cell lymphoma: This rare type affects your skin.
• Waldenstrom macroglobulinemia: This rare disease is also known as lymphoplasmacytic lymphoma. It typically starts in your bone marrow but may also develop in parts of your lymphatic system.
• Mantle cell lymphoma: This type often develops in your lymph nodes, bone marrow and spleen. But it can also develop in other organs, like those in your gastrointestinal tract.
• Marginal zone lymphoma: There are different types of marginal zone lymphoma. Some develop in your stomach, lungs, skin, thyroid, salivary glands and tissues around your eyes.

B-cell lymphoma symptoms

This condition may not cause symptoms right away. For example, people with follicular lymphoma and other types of indolent B-cell lymphoma often receive a diagnosis after a test for an unrelated condition. When symptoms develop, they may include:

• Abdominal (belly) pain
• Drenching night sweats
• Enlarged spleen or liver
• Fatigue
• Itchy skin
• Loss of appetite
• Rashes or skin lumps
• Swollen lymph nodes
• Unexplained fever
• Unexplained weight loss

Having one or more of these symptoms doesn’t mean you have B-cell lymphoma. But you should talk to a healthcare provider if your symptoms get worse or don’t go away within a couple of weeks.

B-cell lymphoma causes

This condition happens when your B cells change (mutate) and become cancer cells. Like most cancers, the condition often develops if there are random changes in cell DNA. This can happen when cells divide and copy DNA to make new cells.

Having any of the following issues may increase your risk of non-Hodgkin lymphoma, including B-cell lymphoma:

• Autoimmune diseases: Examples include rheumatoid arthritis and Sjögren’s syndrome, and inflammatory bowel diseases, like Crohn’s disease and ulcerative colitis.
• Viral diseases: Epstein Barr virus (EBV), hepatitis B and hepatitis C are examples.
• Biological family medical history: You have increased risk if a close family member has Hodgkin lymphoma.
• Obesity: This condition may increase your risk.
• Weak immune system: Conditions like HIV can weaken your immune system. So can medications needed after an organ transplant.

How doctors diagnose this condition

A healthcare provider will ask about your symptoms and your medical history. They’ll do a physical exam that may focus on your lymph nodes, liver and spleen.

They may refer you to a hematologist-oncologist, a provider who specializes in diagnosing and treating blood cancer. You may have blood tests, imaging tests and a biopsy.

Blood tests

Blood tests for cancer give your healthcare provider a view of your overall health. Specific tests may include:

• CBC with differential: This test measures and counts your blood cells and platelets, including your B cells.
• CMP: This test checks for certain substances that may be signs of B-cell lymphoma.
• LDH levels: High LDH levels may be a sign of lymphoma or other diseases.

Your provider may do tests for certain viruses, like HIV and hepatitis.

Imaging tests

Your provider may order the following tests to look for lymphoma in your lymph nodes, liver or spleen:

• CT scans
• PET scans
• Ultrasound

Biopsy

A biopsy to obtain lymph node tissue is the only way your provider can confirm you have B-cell lymphoma. A medical pathologist will examine lymph node tissue samples to identify the lymphoma type. Biopsies may include:

• Bone marrow biopsy: Providers use a special biopsy needle to remove a small piece of bone marrow for examination.
• Excisional or incisional biopsy: In these procedures, a surgeon makes cuts in your body to remove lymph nodes.
• Fine-needle aspiration (FNA): This procedure involves using a fine needle and a syringe to pull out lymph node cells.

How are B-cell lymphomas treated?

There’s no single treatment for this condition. Your provider will recommend the most effective treatment that causes the fewest side effects. You may have:

• Chemotherapy: Anticancer medications kill cancer cells. Your provider may use chemotherapy along with radiation therapy or immunotherapy.
• Immunotherapy: This treatment uses your immune system to find and kill B-cell lymphoma cancer cells. Possible treatments are CAR T-cell therapy or monoclonal antibody therapy.
• Radiation therapy: This may be a main treatment for early-stage B-cell lymphoma. You may have chemotherapy along with radiation therapy.
• Targeted therapy: These therapies include systemic medications that block growth signals inside the cancer cell.

Your provider may recommend you participate in a clinical trial, where researchers explore new treatments or combinations of existing treatments. Clinical trials often represent the cutting edge of available treatments.

Some types of B-cell lymphoma grow very slowly and don’t cause symptoms. If that’s your situation, your provider may delay treatment while they keep a close eye on your health. They may call this active surveillance or watchful waiting.

When should I see my healthcare provider?

You’ll see your hematologist-oncologist and other care team members throughout treatment. They’ll manage your treatment and monitor your overall health. But don’t hesitate to contact them if you have treatment side effects that are more severe than you expect. And let them know if your symptoms get worse.

When you finish treatment, your provider may recommend a schedule of regular follow-up appointments. They’ll check your health and look for signs that B-cell lymphoma has come back.

What can I expect if I have a type of B-cell lymphoma?

There are many types of this condition. Some are more serious than others. In general, what you can expect after treatment depends on factors like:

• The disease type
• How well treatment works
• Your overall health

Ask your cancer care team to explain what may happen after treatment. They’re your best resource for information.

What are B-cell lymphoma survival rates?

A cancer survival rate is an estimate of the percentage of people with a specific cancer who are alive five years after diagnosis.

There are many types of B-cell lymphoma. That makes it hard to estimate an overall survival rate. Experts can estimate individual disease survival rates, including:

• Diffuse large B-cell lymphoma: Overall, 6 out of 10 people are alive five years after their diagnosis.
• Follicular lymphoma: Overall, 9 out of 10 people are alive five years after their diagnosis.

When you think about overall survival rates, keep in mind that several factors may affect your situation. And it’s important to remember the rates are estimates based on data gathered over several years. Newer treatments typically help people live longer.

Is B-cell lymphoma a type of leukemia?

Both conditions affect your white blood cells. But B-cell lymphoma starts in your lymphatic system. Leukemia starts in your blood or bone marrow.

What are B symptoms?

The term “B symptoms” refers to three signs of aggressive B-cell lymphoma: drenching night sweats, a fever with no known cause and losing weight without trying.