Treatment Options for B-Cell Lymphoma (2023)

Although B-cell lymphoma always originates from white blood cells called B-cells, different B-cell lymphomas differ in their aggressiveness, prognosis and response to treatment. Some B-cell lymphomas can be cured while others cannot be cured.

types of treatment

There are several treatment options if you have B-cell lymphoma. Your doctor will determine the type of treatment you receive based on the following factors:

• The type of B-cell lymphomaYou have
• How fast is it growing?
• Where is cancer found in your body?
• your symptoms
• your age
• your overall health

chemotherapy

chemotherapyit is the main method of treating most types of B-cell lymphoma. It involves the use of drugs to suppress the growth of cancer cells or kill cancer cells. Treatment is systemic, meaning the entire body is exposed to anti-cancer drugs. It is given intravenously (IV) or orally as a tablet.

Systemic treatments are needed when the cancer has spread beyond its original site (metastasis) or if availableChancethat spreads chemotherapy can also be given in combination with radiation and immunotherapy.

radiotherapy

radiotherapyIt can also be used to treat B-cell lymphoma. It uses beams of high-energy focused photons to kill the genetic material (DNA) in cancer cells and shrink tumors.

Unlike chemotherapy, which exposes the entire body to cancer-fighting drugs, radiation therapy is a local treatment. This means that the high doses of radiation used are often targeted and only affect the part of the body to be treated.

Although radiation therapy is specific, nearby normal cells can also be affected by the radiation.However, most recover and return to normal work. Even radiation therapy does not kill cancer cells immediately. It can take days or weeks of treatment to damage the DNA enough to kill cancer cells.

immunotherapy

immunotherapyincludes cancer treatments that use your immune system to fight cancer cells. There are several aggressive types of B-cell lymphoma, including DLBCL,Mantle Cell Lymphoma (MCL), primary effusion lymphoma (PEL) andBurkitt-lymphoma.

Immunotherapy is based on the theory that your immune system already knows how to identify, tag and eliminate foreign pathogens such as bacteria and viruses that enter the body. Using the same approach, cancer cells can also be marked as abnormal and killed by the immune system.

CAR-T-Zelltherapie

Chimeric antigen receptor (CAR) T-cell therapy is a type of immunotherapy that uses a person's own immune cells to treat cancer cells.

T cellswho are a kind ofwhite blood cells (WBC), are taken from a person's blood and genetically engineered to produce chimeric antigen receptors (CARs) that can recognize proteins (antigens) present on the surface of cancer cells.

After the modified immune cells are reinfused, their changes cause them to attach to and kill cancer cells. The immune cells then multiply in the body and work to eradicate the cancer.

Drugs for targeted therapy

Targeted treatments are drugs that aim to attack specific proteins on lymphoma cells, such as B. B cell lymphoma (BCL-2) proteins. The BCL-2 proteins are a group of regulatory proteins that control programmed cell death (apoptosis) in cancerous B cells.Without making these proteins, cancer cells stop dividing and die.

In general, targeted treatments attack lymphoma cells more precisely than chemotherapy. This is because they can kill lymphoma cells faster without affecting neighboring healthy cells, resulting in fewer side effects.

The most common targeted therapies for B-cell lymphoma are inhibitors of B-cell receptor (BCR) signaling. BCR pathway inhibitors block signals in cancer B cells that are needed to produce BCL-2 proteins on cell surfaces.

Depending on the severity of your B-cell lymphoma, some targeted treatments are given alone, while others are given along with chemotherapy.

stem cell transplant

Astem cell transplant(also known as bone marrow transplantation) is sometimes used to treat lymphoma, including B-cell lymphoma, in patients who are in remission or have come back during or after treatment.Stem cell transplants also allow health workers to give higher doses of chemotherapy, sometimes along with radiation therapy.

Under normal circumstances, the amount of chemotherapy given is limited to avoid life-threatening side effects (such as severe damage to the bone marrow, which makes red and white blood cells).

With a stem cell transplant, healthcare professionals can give patients high doses of chemotherapy because they may later receive a hematopoietic stem cell transplant to restore bone marrow.

Factors that determine your best treatment option

There are many different types of B-cell lymphoma. Treatment usually depends on both the type of lymphoma and the stage of the disease, but many other factors may also be important.

Type B cell lymphoma

The two main types of B-cell lymphoma are diffuse large B-cell lymphoma (the most common type of B-cell lymphoma) and follicular lymphoma. DLBCL tends to grow rapidly, and treatment usually involves chemotherapy with a four-drug regimen known as CHOP:

• C: Cytoxan (Cyclophosphamid)
• H: Adriamicina (hidroxidaunorrubicina)
• Ö: Oncovin (Vincristina)
• PAG: Prednisone

The immunotherapy drug Rituxan (rituximab) is often added to chemotherapy. This combination is called R-CHOP, a common method used to treat B-cell lymphoma.

Although follicular lymphoma grows slowly and responds well to treatment, it is difficult to cure.Common treatments include R-CHOP and radiation therapy. If these treatments don't work well, they can be treated with various chemotherapy drugs, immunotherapy (CAR-T), or stem cell transplants.

Progressionsrate

Some types of B-cell lymphoma are indolent (slow growing), includingsmall lymphocytic lymphoma (SLL)and chronic lymphocytic leukemia (CLL). If your cancer hasn't spread beyond the lymph nodes and isn't posing an immediate risk to your health, you may not need treatment right away.Your doctor may use the watchful waiting approach, where your health is closely monitored until symptoms appear or change.

However, treatment is usually given soon after aggressive types of B-cell lymphomas, such as DLBCL and Burkitt's lymphoma, are diagnosed.

Location

It's important for your doctor to know the location of your B-cell lymphoma in order to determine the best treatment plan. For example, you may only need radiation therapy aimed at a specific area of ​​the body and not chemotherapy if the cancer hasn't spread.

However, people who are at higher risk of later recurrence of lymphoma in the tissues around the brain and spinal cord can be treated with chemotherapy injected into the cerebrospinal fluid (called intrathecal chemotherapy).

symptoms

If your B-cell lymphoma is not causing severe symptoms, your doctor may place you under active surveillance (watchful waiting) until you need treatment.

Alter

Non-Hodgkin lymphoma is less common thanHodgkin lymphomain young adults, but NHL risk increases with age.According to the American Cancer Society, the median age at diagnosis of DLBCL is in the mid-60s.

NHL can also occur in young adults. In this age group, it tends to grow rapidly and requires intensive treatment. But this population also tends to respond better to treatment than NHL in older adults.

Health

If you have other health problems, less intense chemotherapy regimens can be used to avoid side effects. Even if the lymphoma has spread to youbone marrow(spongy part of bone that makes stem cells) or blood, a stem cell transplant may not be a viable option because it can be difficult to obtain a sample of cancer-free stem cells.

what to expect

During your B-cell lymphoma treatment, a wide range of medical specialists ensure that you receive the best possible care.

Your medical team will likely include a hematologist (a doctor specializing in the blood, bone marrow, and lymphatic system), oncologists (doctors specializing in cancer treatment), nutritionists, and more. They help you make health decisions and guide you through treatment.

forecast

According to the National Cancer Society, the five-year relative survival rate for people with NHL is 72%.However, survival rates can vary widely for different types and stages of B-cell lymphoma.

For diffuse large B-cell lymphoma, the 5-year survival rate is 73% in local or regional spread, but 57% in patients with distant spread. The prognosis for follicular lymphoma is better, with a 5-year survival rate of 96% for local spread, 90% for regional spread, and 85% for distant spread.

Note that this data is based on people diagnosed at least five years ago. It does not reflect a newer treatment that may be more effective. In addition, many individual factors of each patient affect their survival.

What if the treatment doesn't work?

If your B-cell lymphoma doesn't respond to initial treatment or comes back later, it can be treated with a variety of chemotherapy drugs, immunotherapies, targeted drugs, or a combination of these. A stem cell transplant may also be an option.

Summary

B-cell lymphoma is a form of non-Hodgkin's lymphoma (NHL) that originates in B cells, which play a key role in the immune system.

Two of the most common B-cell lymphomas are diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma, and they can vary significantly in their aggressiveness, prognosis, and response to treatment. Some B-cell lymphomas can be cured, while others cannot.

Treatment depends on many factors, such as the person's age, general health, and the type of NHL they have. Health care professionals often use a combination of treatments for NHL, including chemotherapy, radiation, targeted therapy, stem cell transplants, and sometimes surgery.

A word from Verywell

Being diagnosed with lymphoma can be stressful and scary. The more you know about the specific type of B-cell lymphoma you have, the sooner you can discuss treatment options with your doctor.

As B-cell lymphoma survival rates improve, it's important to take good care of your physical and mental health. Try to eat healthily and talk to a nutritionist if you have trouble eating.

Some lymphoma treatments can also make you lethargic, so make sure you're getting enough sleep. You can also incorporate stress-reducing activities (yoga, meditation, and breathing exercises).