StagingNCBISkiptomaincontentSkiptonavigationResourcesHowToAboutNCBIAccesskeysMyNCBISignintoNCBISignOutNCBIBookshelf.AserviceoftheNationalLibraryofMedicine,NationalInstitutesofHealth.StatPearls[Internet].TreasureIsland(FL):StatPearlsPublishing;2021Jan-.StatPearls[Internet].ShowdetailsTreasureIsland(FL):StatPearlsPublishing;2021Jan-.SearchtermDiffuseLargeBCellLymphomaSandeepA.Padala;AvyaktaKallam.AuthorInformationAuthorsSandeepA.Padala1;AvyaktaKallam2.Affiliations1AugustaUMC/MedicalCollegeofGeorgia2UniversityofNebraskaMedicalCenterLastUpdate:August2,2021.ContinuingEducationActivityDiffuselargeBcelllymphoma(DLBCL)isthemostcommonlymphoma,accountingforabout25%to30%ofallthenon-Hodgkinlymphomas.Ittypicallypresentsasarapidlygrowingmassorenlarginglymphnodesinanodalorextranodalsite.Thoughaggressive,theydorespondwelltosixcyclesofrituximabalongwithcyclophosphamide,doxorubicin,vincristine,andprednisone(R-CHOP).ThisactivityreviewstheevaluationandtreatmentofDLBCLandhighlightstheroleoftheinterprofessionalteaminevaluatingandtreatingpatientswiththiscondition.Objectives:DescribethepathophysiologyoftheBcelllymphomas.Reviewtheworkupofthepatientswithlymphoma.OutlinesthetreatmentofBcelllymphomas,asitdependsnotonlyontheirstagingbutalsoonthetypeofthedisease(indolentoraggressive)andthemolecularsubtype.SummarizetheroleoftheinterprofessionalteammembersinoptimizingcollaborationandcommunicationtoensurepatientswithDLBCLreceivehigh-qualitycare,whichwillleadtobetteroutcomes.Accessfreemultiplechoicequestionsonthistopic.IntroductionLymphomaisthemalignancyofthelymphocytesinthelymphoidsystem,andthey canarise fromBlymphocytesorTlymphocytesorthenaturalkiller(NK)cellsduringtheirdifferentstagesofmaturation.ItcanbeclassifiedintoHodgkinsandNon-Hodgkinslymphoma(NHL). NHLconstitutesabout80%ofalllymphomas.B-cellsareknowntohavefunctionaldiversityandpropertyto transformintomultiplepathways.[1] Due toitsfunctionaldiversity,itrepresentsaheterogeneousgroupofdiseasesvaryingclinicallyandpathologically. Morethan30subty

Whatpatientsandcaregiversneedtoknowabout cancer,coronavirus,andCOVID-19.CloseCriticalAlertBannerSearchVerenespañol|Downloadthistopic[PDF]TreatingNon-HodgkinLymphomaChemotherapyforNon-HodgkinLymphomaImmunotherapyforNon-HodgkinLymphomaTargetedDrugTherapyforNon-HodgkinLymphomaRadiationTherapyforNon-HodgkinLymphomaHigh-DoseChemotherapyandStemCellTransplantforNon-HodgkinLymphomaSurgeryforNon-HodgkinLymphomaPalliativeandSupportiveCareforNon-HodgkinLymphomaTreatingB-CellNon-HodgkinLymphomaTreatingT-CellNon-HodgkinLymphomaTreatingHIV-AssociatedLymphomaCancerA-ZNon-HodgkinLymphomaTreatingNon-HodgkinLymphomaTreatingB-CellNon-HodgkinLymphomaNon-Hodgkinlymphoma(NHL)isgenerallydividedinto2maintypes,basedonwhetheritstartsinBlymphocytes(Bcells)orTlymphocytes(Tcells).TherearemanydifferenttypesofB-celllymphomas.Treatmentusuallydependsbothonthetypeoflymphomaandthestage(extent)ofthedisease,butmanyotherfactorscanbeimportantaswell.DiffuselargeB-celllymphomaDiffuselargeB-celllymphoma(DLBCL)tendstogrowquickly.Mostoften,thetreatmentischemotherapy(chemo),usuallywitharegimenof4drugsknownasCHOP(cyclophosphamide,doxorubicin,vincristine,andprednisone),plusthemonoclonalantibodyrituximab(Rituxan).Thisregimen,knownasR-CHOP,ismostoftengivenincycles3weeksapart.Becausethisregimencontainsthedrugdoxorubicin,whichcandamagetheheart,itmaynotbesuitableforpatientswithheartproblems,sootherchemoregimensmaybeusedinstead.StageIorIIForDLBCLthatisonlyin1or2lymphnodegroupsonthesamesideofthediaphragm(thethinmusclethatseparatesthechestfromtheabdomen),R-CHOPisoftengivenfor3to6cycles,whichmightbefollowedbyradiationtherapytotheaffectedlymphnodeareas.StageIIIorIVMostdoctorswillgive6cyclesofR-CHOPasfirst-linetreatment.Afterseveralcycles,doctorsmaygetimagingtestssuchasaPET/CTscantoseehowwelltreatmentisworking.Peoplewhohaveahigherriskofthelymphomacomingbacklaterinthetissuesaroundthebrainandspinalcordmaybetreatedwithchemoinjectedintothespinalfluid(calledintrathecalchemotherapy).Anotheroptionistogivehighdosesofmethotrexatein

Whattoknowaboutstage4lymphomaMedicallyreviewedbyChristinaChun,MPH—WrittenbyShannonJohnsononDecember11,2018TypesSymptomsTreatmentOutlookSurvivalSummaryStage4lymphomaoccurswhencancerhasspreadtoadistantpartofthebodyoutsideofthelymphaticsystem,suchasthespinalcord,lungs,orliver.Lymphomaiscancerthatoriginatesinatypeofwhitebloodcellcalledlymphocytes.Thesecellstravelthroughthelymphaticsystem,whichispartofthebody’simmunesystem.Aswithmanycancers,therearefourstagesoflymphoma.Stage4(IV)lymphomaisoftentreatable.Aperson’sprognosisdependsonmanyfactors,whichincludethetypeoflymphomaandtheageoftheindividual.Inthisarticle,wediscussthedifferenttypesoflymphoma,includingtheirsymptoms,treatment,andsurvivalrates.Typesofstage4lymphomaLymphomaisthetermthatpeopleusetodescribecancerthatdevelopsinthelymphaticsystem.Therearetwomaintypesoflymphoma:Hodgkinlymphomaandnon-Hodgkinlymphoma.HodgkinlymphomaShareonPinterestStage4lymphomaoccurswhencancerhasspreadbeyondthelymphaticsystem.ThehallmarkofHodgkinlymphomaisthepresenceofReed-Sternbergcells,whicharematureB-typeimmunecellsthathavebecomecancerous.Anestimated95percentofHodgkinlymphomasareclassicHodgkinlymphoma,ofwhichtherearefoursubtypes:nodularsclerosismixedcellularitylymphocyte-richlymphocyte-depletedAround5percentofpeoplewithHodgkinlymphomahavenodularlymphocyte-predominantHodgkinlymphoma.EachdifferentsubtypeofHodgkinlymphomahasuniquecharacteristicsthatwilldetermineitstreatmentoptions.Non-HodgkinlymphomaNon-Hodgkinlymphoma,incontrasttoHodgkinlymphoma,cancomefromB-typeorT-typeimmunecells.Itcanalsoforminthelymphnodesandotherorgans,suchasthestomach,intestines,andskin.Therearemorethan90typesofnon-Hodgkinlymphoma,anditispossibletoclassifythemindifferentways.Forexample,doctorsmayclassifynon-HodgkinlymphomaaseitherT-cellorB-cell,accordingtothetypeoflymphocytethatitaffects.Alternatively,theymaydescribethelymphomaasindolentoraggressivetoreflecthowfastitgrowsandspreads.AswithHodgkinlymphoma,thetypeofnon-Hodgkinlymphomawilldeterminethetreatment.SymptomsShareo

Understand Your Stage. Doctors divide DLBCL into four stages. Here's what they mean: Stage I: The cancer is in one lymph node area, ...DiffuseLargeB-CellLymphoma1/11StagingDiffuseLargeB-CellLymphomaAfterdoctorsdiagnosediffuselargeB-celllymphoma(DLBCL),they’lldomoreteststofindoutwherethecancerisinyourbodyandhowfarithasspread.Thisprocessiscalledstaging.Youmightgetthesetests:PhysicalexamBloodtestsBonemarrowbiopsyImagingtestsThesetestresultsandthestageofthecancerhelpdoctorstodecidethebestwaytotreatyourcancer.Swipetoadvance2/11UnderstandYourStageDoctorsdivideDLBCLintofourstages.Here’swhattheymean:StageI:Thecancerisinonelymphnodearea,lymphstructure,orothersite.StageII:Thecancerisintwoormorelymphnodeareasorstructuresononesideofthediaphragm,thelargemusclethatseparatestheabdomenfromthechest.StageIII:Thecancerisinlymphnodeareasorstructuresonbothsidesofthediaphragm.StageIV:Thecancerhasspreadtootherorgansandtissues.Thismayincludetheliver,lung,orbonemarrow.Swipetoadvance3/11StagingandTreatmentIt’sbestwhenthecancerisinanearlierstage.Butthestagecan’ttellyouhowwellyourtreatmentwillworkorwhatthefuturewillhold.Yourdoctorwillusethestagealongwithotherthingslikeyourgeneralhealthandagetosetyourtreatmentplan.TreatmentforDLBCLmayinclude:ChemotherapyImmunotherapySteroidsRadiationtherapyTargetedtherapyStemcelltransplantCART-celltherapySwipetoadvance4/11TreatingAdvancedDLBCLThemostcommontreatmentforadvancedDLBCLiscalledR-CHOP.Thistreatmentcombinesthreechemotherapydrugswithanantibodyandasteroid.Theyare:Rituximab(Rituxan)Cyclophosphamide(Cytoxan)Hydroxydaunorubicin(Doxorubicin)Vincristine(Oncovin)PrednisoneDoctorsoftengiveR-CHOPevery3weeksforsixtoeightcycles.Mostpeoplewillhavesideeffects,whichmayincludefever,lowbloodcounts,andnausea.Forpeoplewithcertainhealthconditions,doctorsmayrecommendothertreatmentcombinations.Swipetoadvance5/11TreatingEarly-StageDLBCLDoctorsalsouseR-CHOPtotreatearly-stageDLBCL.Theymayusefewercycles--threeinsteadofsixoreight--togetherwithradiationtherapy.Doctorsmostoftengiv

SkipToMainContentPrescribingInformationDLBCLStagesThe4stagesofDLBCL Stagingdescribeshowfarlymphomahasspread.KeepinmindthateventhemostadvancedstagesofdiffuselargeB-celllymphoma(DLBCL)(StageIIIandStageIV)arecommonandcanbetreated.NEXT:GoalsoftreatmentImportantSafetyInformation&IndicationsBacktoTopIndicationsRITUXANHYCELA®(rituximab/hyaluronidasehuman)isaprescriptionmedicineusedtotreatadultswith:FollicularLymphoma(FL)asasingle-agenttherapyinpatientswhosediseaserecurredordidnotrespondtoinitialtreatmentFollicularLymphomaasaninitialtreatmentwithchemotherapyand,inpatientswhoseinitialtreatmentwassuccessful,asasingle-agentfollow-uptherapyFollicularLymphomaasasingleagentfollow-uptherapyforpatientswhodidnotprogressoninitialtreatmentwithCVPchemotherapyDiffuseLargeB-CellLymphoma(DLBCL)asaninitialtreatmentincombinationwithCHOPorotheranthracycline-basedchemotherapyregimensChronicLymphocyticLeukemia(CLL)incombinationwithFCchemotherapyasaninitialtreatmentorasatreatmentafterdiseasehasrecurredYoucanonlyreceiveRITUXANHYCELAafteryoureceiveatleast1fulldoseofintravenous(IV)RITUXAN®(rituximab).ReadtheIVRITUXANMedicationGuideformoreinformationaboutsevereinfusionreactions,whichusuallyhappenduringthefirstdosewithIVRITUXANRITUXANHYCELAisnotforusetotreatmedicalconditionsotherthancancersItisnotknownifRITUXANHYCELAissafeandeffectiveinchildrenWhatisthemostimportantinformationIshouldknowaboutRITUXANHYCELA?RITUXANHYCELAcancauseserioussideeffectsthatcanleadtodeath,including:Severeskinandmouthreactions:TellyourhealthcareproviderorgetmedicalhelprightawayifyougetanyofthesesymptomsatanytimeduringyourtreatmentwithRITUXANHYCELA:painfulsoresorulcersonyourskin,lips,orinyourmouth;blisters;peelingskin;rashorpustulesHepatitisBvirus(HBV)reactivation:BeforeyoureceiveRITUXANHYCELA,yourdoctorwilldobloodteststocheckforHBVinfection.IfyouhavehadhepatitisBorareacarrierofhepatitisBvirus,receivingRITUXANHYCELAcouldcausethevirustobecomeanactiveinfectionagain.HepatitisBreactivationmaycauseseriousliverproblemsincludingliverf

TogglenavigationCOVID-19AboutAboutTheASCOPostEditorialBoardRightsandPermissionsContactSubscribeNewsFDAUpdateJournalSpotlightExpert'sCornerIntheClinicViewByIssueViewAllMeetingsAACR-NCI-EORTCVirtualInternationalConferenceonMolecularTargetsandCancerTherapeutics14thAACRConferenceontheScienceofCancerHealthDisparitiesinRacial/EthnicMinoritiesandtheMedicallyUnderserved2021ASCOQualityCareSymposiumESMOCongress2021SOHO2021CalendarViewAllTopicsBreastCancerLungCancerProstateCancerLymphomaViewAllVideosNewsreelsVideoRoundtablesPodcastsSubscribeAdvertisementChallengesofManagingOlderPatientsWithDiffuseLargeB-CellLymphomaByColetteN.Owens,MDSeptember10,2018AdvertisementColetteN.Owens,MDAsthepopulationcontinuestoage,theinterplaybetweenagingandcancerincreasinglyshowscancertobeadiseaseofolderpeople.Bytheyear2030,therewillbeanincreasedincidenceofnon-Hodgkinlymphoma(NHL)inolderindividuals.1ThemedianageofpatientsdiagnosedwithdiffuselargeB-celllymphoma(DLBCL)is70yearsold,andgiventhesedemographicchanges,oncologistswillincreasinglyberequiredtomanageolderpatientswithDLBCLinthecontextofcomorbidityandage-relatedorgandysfunction.DLBCLisanaggressiveNHLthatiscurablewithfront-linetherapywithananthracycline-basedchemoimmunotherapy,withoverallsurvivalratesof60%to70%.2,3However,thisrepresentsthebestopportunityforcure,asthosewithrelapsedorrefractorydiseaseoftendieofthedisease.StuartM.Lichtman,MDGiventhiscontext,therearesignificantchallengesinoptimizingtherapyforolderpatientsinthecontextofdiseaseandpatientfactors.Fromapracticalstandpoint,theinitialassessmentofolderpatientswithDLBCLisevolvingnotonlytoincludediseasestagingandbiologicriskfactors,butalsooncogeriatricriskassessments.LifeExpectancyCONSIDERATIONOFlifeexpectancyisimportantinchoosingatherapyforolderpatients.Theaverage80-year-oldhasapredictedlifeexpectancyofapproximately5years,andthus,DLBCLismostlikelythegreatestrisktothepatient,exceptforthefrailestpatientswithalifeexpectancyoflessthan1year.4GUESTEDITORGeriatricsfortheOncologistisguesteditedbyStua

Systems for staging diffuse large B-cell lymphoma (DLBCL) are provided below, including the World Health Organization (WHO)/Revised European ...ForYouNews&PerspectiveDrugs&DiseasesCME&EducationAcademyVideoDecisionPointEdition:ENGLISHDEUTSCHESPAÑOLFRANÇAISPORTUGUÊSLogInSignUpIt'sFree!Edition:ENGLISHDEUTSCHESPAÑOLFRANÇAISPORTUGUÊSRegisterLogInNoResultsNoResultsForYouNews&PerspectiveDrugs&DiseasesCME&EducationAcademyVideoDecisionPointclosePleaseconfirmthatyouwouldliketologoutofMedscape.Ifyoulogout,youwillberequiredtoenteryourusernameandpasswordthenexttimeyouvisit.LogoutCancelhttps://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cDovL2VtZWRpY2luZS5tZWRzY2FwZS5jb20vYXJ0aWNsZS8yMDA3Nzg5LW92ZXJ2aWV3processing....Drugs&Diseases>OncologyDiffuseLargeB-CellLymphoma(Non-HodgkinLymphoma)Staging Updated:Dec10,2020Author:FranciscoJHernandez-Ilizaliturri,MD;ChiefEditor:MatthewCFoster,MD more...ShareEmailPrintFeedbackCloseFacebookTwitterLinkedInWhatsAppSectionsDiffuseLargeB-CellLymphoma(Non-HodgkinLymphoma)StagingSectionsDiffuseLargeB-CellLymphoma(Non-HodgkinLymphoma)StagingStagingofDiffuseLargeB-CellLymphomaQuestions&AnswersShowAllTablesReferencesStagingofDiffuseLargeB-CellLymphomaSystemsforstagingdiffuselargeB-celllymphoma(DLBCL)areprovidedbelow,includingtheWorldHealthOrganization(WHO)classification[1,2]andtheCotswoldsmodificationoftheAnnArborsystem.RiskstratificationwiththeInternationalPrognosticIndex(IPI)scoreisalsoprovided.[3]WHOclassificationDLBCL,nototherwisespecified(NOS)includesthefollowing:GerminalcenterB-celltypeActivatedB-celltypeOtherformsincludethefollowing:PrimaryDLBCLofthecentralnervoussystem(CNS)PrimarycutaneousDLBCL,legtypeEpstein-Barrvirus(EBV)–positiveDLBCLNOSDLBCLassociatedwithchronicinflammationHumanherpesvirus8(HHV8)–positiveDLBCL,NOSTable.CotswoldsmodificationofAnnArborstagingsystem(OpenTableinanewwindow)StageAreaofInvolvementISinglelymphnodegroupIIMultiplelymphnodegroupsonsamesideofdiaphragmIIMultiplelymphnodegroups