A version of this story also appears on Reader’s Digest.
Non-Hodgkin’s lymphoma (NHL) is one of the most common types of blood cancer, with some 80,000 people in the U.S. diagnosed with the disease each year.1,2 Of the more than 60 subtypes of NHL, the most common is an aggressive one – diffuse large B-cell lymphoma (DLBCL).3
NHL begins in white blood cells, called lymphocytes, which are part of the immune system.4 This type of cancer develops when a lymphocyte undergoes a malignant (cancerous) change and then multiplies, creating tumors in lymph nodes, lymphatic tissue or the spleen.1,5,6
DLBCL is a fast-growing type of NHL in which B lymphocytes, white blood cells in the lymphatic system that produce antibodies to fight infections, are affected. DLBCL grows rapidly in the lymph nodes and frequently involves the spleen, liver, bone marrow or other organs.6 Although the disease can affect people of any age, it most commonly occurs in older adults, and the median age at the time of diagnosis is 67.7
Early signs and symptoms of DLBCL
The most common early sign of DLBCL is painless swelling in one or more lymph nodes, commonly observed in the neck, groin or abdomen. However, the disease may begin somewhere other than the lymph nodes, such as the bones or lungs or even skin,5 making DLBCL challenging to detect and diagnose. In fact, about 60% to 70% of people with this type of NHL are not diagnosed until the disease is in an advanced stage.8 Because of its aggressive nature, DLBCL should be diagnosed and treated as early as possible, so it’s important for people experiencing unusual symptoms to be proactive and consult a healthcare provider.
Standard and emerging treatment options for people diagnosed with DLBCL
The most common initial (first-line) treatment for DLBCL is chemotherapy plus immunotherapy.5 This regimen became the standard of care for newly diagnosed DLBCL nearly 20 years ago.9 While effective for many, approximately 40% of patients never respond to initial treatment or they relapse after an initial response.10 At that point, treatment options remain limited and those patients have a poor prognosis, with a median overall survival of 6.3 months.11
Researchers are evaluating the potential of new types of therapies to improve outcomes for people with DLBCL.9 The goal of such research is to find therapies that could prolong patients' lives while helping them maintain their quality of life.
Important treatment options are currently under investigation to treat people with first-line DLBCL - including antibody-drug conjugates (ADCs), a type of targeted therapy that uses antibodies to deliver potent chemotherapy to cancer cells with the goal of mitigating some of the toxicity and side effects associated with systemic chemotherapy, and bispecific antibodies, designed as a chemotherapy-free option that targets the cancer cells by recruiting the immune system to destroy them.
Research in DLBCL is also investigating different modes of administration and dosing regimens in an effort to improve patient treatment experiences. For example, fixed-duration treatment regimens are currently being explored, which may enable therapy to be administered for a specific amount of time rather than treating until the cancer progresses.
Advancements and innovations such as ADCs and bispecific antibodies may offer additional options for people diagnosed with this aggressive and often difficult to treat lymphoma.
To learn more about DLBCL and other blood cancers, visit Genentech’s Hematology Hub.