b cell non hodgkin's lymphoma | Large-cell diffuse lymphoma B

Large-cell diffuse lymphoma B

Large B-cell diffuse lymphoma (LDGCB) is the most common type of non-Hodgkin's lymphoma (NHL). When observed under a microscope, lymphoma cells appear to be very large compared to normal lymphocytes. Lymphoma cells are also dispersed in all lymph nodes and tissues.

LDGCB can occur in people of all ages, but most receive their diagnosis when they reach mid-sixties. It affects humans a little more often.

In general, LDGCB originates in the lymph nodes, but it can also be done in organs or tissues that lie outside the lymph nodes (primitive extraganglionnaire disease) and the most common sites Include the following:

Bone
Brain or spinal cord (central nervous system, or CNS)
Gastrointestinal tract
Sinus
Testicles
thyroid gland
Skin
In 30 to 40% of cases, LDGCB is located (Stage 1 or 2) when diagnosed. The others are prevalent at the time of diagnosis, which means that the LDGCB has spread to the lymph nodes above and below the diaphragm or to different parts of the body, such as spleen, liver or bone marrow.

The rare subtypes of LDGCB are among other things:

Primary mediastinal lymphoma with large B cells
Primitive serous lymphoma (LPS)
Large-cell intravascular lymphoma B
The LDGCB is a rapidly evolving (aggressive) NHL type. Some types of B-lymphoma that evolve slowly (indolent) can become LDGCB. These are among other things:

Follicular lymphoma
MALT lymphoma
Lymphoma of the splenic marginal zone
Small lymphocyte lymphoma
Lymphoplasmocytaire lymphoma
Symptoms
In the case of LDGCB, lymph nodes become larger than normal, which is why they can be felt at the touch. B symptoms, such as unexplained fever, significant night sweats and unexplained weight loss can also occur.

Treatments
LDGCB is highly susceptible to chemotherapy, so it is used as a primary treatment. Although the LDGCB is a rapidly evolving type of NHL, chemotherapy is effective for many people. It is possible that the LDGCB reappears (recurrence) after the first treatment sessions have been administered.

Chemotherapy

Chemotherapy is used to treat all stages of the LDGCB. The chemotherapeutic Association most often administered as the initial treatment of LDGCB is called CHOP and consists of:

Cyclophosphamide (Cytoxan, Procytox)

Doxorubicin (Adriamycin)

Vincristine (Oncovin)

Prednisone

Chemotherapy is usually administered with a targeted drug. We are talking about the R-CHOP Protocol, the association chemotherapeutic CHOP and the Rituximab (Rituxan).

If the LDGCB reappears after being treated or not responding to the treatment, the following chemotherapeutic agents will be administered:

R-GDP – Gemcitabine (Gemzar), dexamethasone (Decadron, Dexasone), cisplatin (Platinol AQ) and rituximab

R-Ptwi – Dexamethasone, Cytarabine (Cytosar, Ara-C), cisplatin and rituximab

Cytarabine

Bendamustine (Treanda)

PEPC – prednisone, etoposide (Vepesid, VP-16), Cyclophosphamide and Procarbazine (Natulan)

R-ICE – Ifosfamide (Ifex), carboplatin (flattened, flattened AQ), etoposide and rituximab

Targeted treatment

Targeted treatment uses drugs to target specific molecules (such as proteins) located on the surface of cancer cells. These molecules contribute to the sending of signals that tell cells to grow or divide. By targeting these molecules, medications interrupt the growth and spread of cancer cells while limiting damage to normal cells.

Rituximab is a targeted drug frequently administered alone or associated with chemotherapy to treat LDGCB.

Radiotherapy

External radiotherapy can be administered after chemotherapy to treat a stage 1 LDGCB, and sometimes stage 2. When the LDGCB appears in a testicle, it is possible to administer radiation therapy to the other testicle also to prevent the spread of lymphoma cells.

Radiotherapy may be administered after chemotherapy in the presence of a more advanced stage LDGCB. It is used if the disease is still present on a small surface or if tumours measuring at least 10 cm in diameter are present in other regions (large disease).

Central nervous system prophylaxis

The central nervous system (CNS) is made of the brain and the spinal cord. The LDGCB that originates in the sinuses or testicles may spread to the CNS. CNS prophylaxis is being done to try to prevent lymphoma cells from propagating to the brain and spinal cord.

CNS prophylaxis may be administered by intrathecal chemotherapy, i.e. the chemotherapeutic agent is injected directly into the cerebrospinal fluid (CSF). The medicine used is methotrexate.

CNS prophylaxis can also be administered using a needle inserted into a vein (intravenous). The drug used is high dose methotrexate.

Stem cell transplant

Alternative treatment options may be proposed to persons whose LDGCB does not disappear after treatment or reappears after being treated (relapse). These treatments may include other types of chemotherapy or stem cell transplant. Stem cell transplant may be an option if LDGCB has already responded to chemotherapy before.