What you need to know about DLBCL
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, accounting for over 30% of all cases. While aggressive, DLBCL is potentially curable for many patients.
What is DLBCL?
DLBCL is a cancer of white blood cells called B lymphocytes. It begins when these B lymphocytes grow uncontrollably, enlarging the lymph nodes and sometimes traveling to other organs, such as the bone marrow, spleen and liver. Symptoms often include night sweats, weight loss and fatigue.
What’s the standard of care?
As with many blood cancers, the first line treatment for DLBCL is chemotherapy. In most cases, patients receive a combination of five medications, known as R-CHOP. R-CHOP, or other more intense treatment combinations, is often successful in curing DLBCL.
If the cancer comes back, we have other options, including additional chemotherapy and autologous (using the patient’s own cells) stem cell transplant. The sequence and amount of each additional therapy depends on the aggressiveness of the cancer and the patient’s response to the therapy.
What treatments are available for relapsed DLBCL?
If a patient isn’t cured after chemotherapy and stem cell transplant, we have different options. In fact, it’s an incredible time when it comes to new drugs and therapies.
In 2019 and 2020 alone, three new treatments were approved for use in relapsed and refractory DLBCL. Examples are antibody-drug conjugates, which are antibodies linked to a “trojan horse” delivery of an anti-cancer drug; oral pathway inhibitors, which selectively block some of the pathways that lymphoma uses to grow; and a new antibody against a common protein on cancerous B cells.
There is also the new field of immunotherapy, where the drugs affect or block how the immune system recognizes cancer. CAR T-cell therapy (which re-engineers white blood cells to fight cancer) has been a game-changer for many patients with blood cancers.
What’s on the horizon for patients with DLBCL?
Treatment for lymphoma will become more targeted, personalized and specific to each patient and their disease. And by analyzing a tumor, we can understand its biology and select optimal treatments while minimizing any toxicities of the medications.