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Why is DLBCL known as the most common lymphoma in adults?
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma in adults. In the United States and the United Kingdom, there are about 7 to 8 new confirmed cases per 100,000 people each year. DLBCL usually occurs in middle-aged and older adults, with the median age at diagnosis being approximately 70 years, but cases have also been reported in younger adults and rare children. This type of lymphoma can occur almost anywhere in the body and often manifests itself in a very aggressive manner.
The usual first sign of this cancer is the observation of a rapidly growing mass or tissue infiltrate, which is sometimes accompanied by systemic B symptoms such as fever, weight loss, and night sweats.
Although the exact cause of diffuse large B-cell lymphoma is unknown, it is generally thought to arise from normal B cells and may also be a result of other lymphomas (especially marginal zone lymphoma) or chronic lymphocytic leukemia. malignant transformation. Among risk factors, underlying immune deficiency significantly increases the likelihood of developing the disease. In addition, the association with infections such as Epstein-Barr virus (EBV), Kaposi's sarcoma-related herpesvirus, human immunodeficiency virus (HIV), and Helicobacter pylori has also received increasing attention.
In general, most cases of DLBCL are associated with the progressive acquisition of increasing genetic mutations and changes in gene expression that progressively promote the malignant behavior of certain B cell types.
DLBCL is usually diagnosed by removing a portion of the tumor and performing a biopsy, followed by microscopic examination of the tissue. Diagnosis by a hematopathologist is very common. There are multiple subtypes of DLBCL that differ in clinical manifestations, biopsy findings, aggressive features, prognosis, and recommended treatment options. Conventional treatment for most DLBCL subtypes is chemotherapy combined with a monoclonal antibody drug, usually rituximab, which specifically targets the cancerous B cells. With these treatments, more than half of DLBCL patients can be cured, while the overall cure rate for elderly patients is slightly lower, and the five-year survival rate is also around 58%.
Subtypes of diffuse large B-cell lymphoma
Diffuse large B-cell lymphoma encompasses a group of disease subtypes with diverse biological and clinical manifestations, many of which are difficult to separate based on clear and widely accepted criteria. According to the World Health Organization's 2008 classification system, more than a dozen subtypes are identified, which are based on the location of the tumor, the presence of other cell types (such as T cells) in the tumor, and whether the patient has certain other conditions associated with DLBCL. And be recognized. In 2016, the World Health Organization reclassified DLBCL based on further research into the most common subtype, diffuse large B-cell lymphoma not otherwise specified (DLBCL, NOS), which represents 80-85% of all DLBCL cases.
About 70% of cases of DLBCL and NOS mainly present in the form of lymph node disease. The most typical manifestations of these cases are located in areas of the body with multiple lymph nodes at the time of diagnosis, such as the groin, armpit, or neck. A rapidly growing mass.
As our understanding of DLBCL and its subtypes increases, researchers continue to explore how to improve the prognosis of these patients. Most patients with DLBCL will experience varying degrees of treatment response, with some cases having a good prognosis with standard treatments and others not. This is why DLBCL is known as the most common lymphoma in adults and is particularly important because of its biological diversity and clinical challenges.
Ultimately, complex situations such as these get us thinking, could this phenomenon help us develop more flexible and precise treatment plans for DLBCL and other lymphomas?
