Everything You Need to Know About B-Cell Lymphoma

B-cell lymphomas are cancers that affect B cells, a type of white blood cell in the lymphatic system. Lymphomas are blood cancers that develop in the lymph nodes. These cancers are more common in older adults and people with weakened immune systems.

B-cell lymphomas make up about 85% of all non-Hodgkin lymphomas. According to the American Cancer Society, approximately 80,600 people were diagnosed with non-Hodgkin lymphoma in 2024. Over 2 million people in the U.S. are projected to receive a cancer diagnosis in the same year.

Classification of B-Cell Lymphomas

B-cell lymphomas include Hodgkin’s lymphoma and most types of non-Hodgkin lymphoma. They are usually classified as either low-grade (indolent) or high-grade (aggressive):

Indolent (slow-growing) lymphomas:

These grow slowly and can be controlled with treatment over many years. Although long-term survival is possible, these lymphomas are generally not considered curable. Some of the more common or notable types include:

Chronic Lymphocytic Leukemia (CLL):

Chronic Lymphocytic Leukemia develops in the blood and bone marrow. It often progresses slowly and can affect the body’s ability to fight infections.

Small Lymphocytic Lymphoma (SLL):

Small Lymphocytic Lymphoma (SLL) is similar to CLL, but the cancer cells mainly reside in the lymph nodes instead of the blood or bone marrow.

Cutaneous B-Cell Lymphoma:

A rare type that begins in the skin. It may cause visible skin lesions, bumps, or rashes, and usually grows slowly over time.

Cutaneous T-Cell Lymphoma:

Cutaneous T-cell lymphoma refers to a group of indolent T-Cell lymphomas that primarily affect the skin and are often limited to that area.

Marginal Zone Lymphomas:

Marginal Zone lymphoma can form in various areas such as the stomach, lungs, skin, thyroid, salivary glands, or tissues around the eyes.

Lymphoplasmacytic Lymphoma (Waldenstrom Macroglobulinemia):

A rare lymphoma that usually grows in the bone marrow and sometimes in other parts of the lymphatic system.

Mantle Cell Lymphoma:

Mantle cell lymphoma often develops in lymph nodes, bone marrow, and the spleen. Clinical trials for mantle cell lymphoma are evaluating new treatment possibilities focused on improving disease control and long-term outcomes.

Follicular Lymphoma:

Follicular lymphoma is the second most common B-cell lymphoma. It can appear in lymph nodes, bone marrow, and other organs. Follicular lymphoma clinical trials are examining whether potential new therapies may help manage the disease more effectively.

Aggressive (fast-growing) lymphomas:

Aggressive B-cell lymphomas grow quickly and can affect different parts of the body. Common types include:

Burkitt Lymphoma:

Burkitt lymphoma is a rare but fast-growing lymphoma that often starts in the stomach and can spread rapidly to other organs.

Bulky Lymphoma:

Bulky lymphoma refers to a lymphoma with large tumor masses, often requiring intensive treatment.

Anaplastic Large Cell Lymphoma (ALCL):

Anaplastic large cell lymphoma is a rare, aggressive lymphoma that can affect lymph nodes, skin, and other organs.

High-Grade B-Cell Lymphoma (HGBCL):

This lymphoma behaves similarly to DLBCL and Burkitt lymphoma. While treatments can bring it into remission, there is a higher likelihood of the disease returning.

Diffuse Large B-Cell Lymphoma (DLBCL):

Diffuse large B-Cell Lymphoma is the most common type of non-Hodgkin lymphoma. There are several subtypes of DLBCL with slightly different characteristics. Moreover, ongoing DLBCL clinical trials are exploring potential new treatment options to improve patient outcomes.

Aggressive B-cell lymphomas usually require intensive treatment, but many patients respond well and have a good chance for long-term remission or cure. Furthermore, knowing the differences between Hodgkin and non-Hodgkin lymphoma is important, as it helps clarify their behavior, treatment strategies, and prognosis.

Symptoms of B-Cell Lymphomas

Symptoms of B-cell lymphomas can vary based on the type and location of the cancer. In some cases, there may be no noticeable symptoms at first. When symptoms do occur, they may include:

• Swollen lymph nodes in the neck, armpits, or groin
• Persistent fatigue or weakness
• Abdominal discomfort or bloating
• Unexplained weight loss
• Loss of appetite
• Drenching night sweats
• Unexplained fever
• Itchy skin (pruritus)
• Rashes or skin lumps
• Enlarged spleen or liver

Causes of B-Cell Lymphoma

B cells are a key part of the immune system, protecting the body from infections and abnormal cells. In B-cell lymphoma, some B cells mutate, grow uncontrollably, resist dying, and can spread to other areas. This usually occurs due to accidental changes during cell replication. Research also shows that certain factors may increase the risk, including:

• Autoimmune diseases: Conditions like rheumatoid arthritis, inflammatory bowel disease, or Sjögren’s syndrome.
• Viral infections: Exposure to viruses such as HIV, Epstein-Barr virus (mononucleosis), or Kaposi sarcoma-associated virus.
• Family history: Having relatives with Hodgkin lymphoma or other lymphomas.
• Obesity: Carrying excess weight may raise the risk of developing certain types of lymphoma.

Diagnosis of B-Cell Lymphoma

Diagnosing B-cell lymphoma typically involves several steps:

• Physical Exam and Medical History: Your doctor checks for swollen lymph nodes, enlarged organs, and gathers information about symptoms and risk factors.
• Blood Tests and Immunophenotyping: Blood tests help detect abnormal cells and determine specific B-cell characteristics.
• Imaging Tests: Scans such as CT, PET, or MRI help locate lymphoma and assess its spread.
• Biopsy: A sample of a lymph node or affected tissue is examined under a microscope to confirm the diagnosis.

B-Cell Lymphoma Staging

After a B-cell lymphoma diagnosis, doctors determine how far the cancer has spread. This is called staging. Tests such as imaging scans, blood tests, and biopsies help identify the stage. Knowing the stage allows the healthcare team to choose the most appropriate treatment plan.

Although staging may vary slightly by lymphoma type, B-cell lymphomas are generally classified into four stages:

Stage 1: Cancer is found in a single lymph node area or in one nearby area outside the lymph nodes.

Stage 2: Cancer affects two or more lymph node areas on the same side of the diaphragm.

Stage 3: Cancer is present in lymph node areas on both sides of the diaphragm.

Stage 4: Cancer has spread beyond the lymph nodes to other organs or tissues, such as the bone marrow, liver, or lungs.

Management and Treatment of B-Cell Lymphoma

Treatment for B-cell lymphoma varies based on the lymphoma type, stage, overall health, and how early the disease is diagnosed. Your oncologist creates a personalized plan that aims to control the cancer while minimizing side effects. Treatment may involve one or more of the following approaches:

Watchful Waiting (Active Surveillance)

For slow-growing B-cell lymphomas without symptoms, treatment may not begin right away. Instead, doctors closely monitor the condition with regular checkups and start treatment if the disease progresses.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells or stop them from growing. It can be given alone or combined with other treatments and may be delivered through an IV or oral medications.

Radiation Therapy

Radiation therapy uses high-energy rays to destroy cancer cells in targeted areas. It is often used for early-stage disease or alongside chemotherapy to improve treatment results.

Immunotherapy

Immunotherapy helps the immune system recognize and attack cancer cells more effectively. Common options include monoclonal antibodies that target specific proteins on B cells.

Targeted Therapy

Targeted therapies focus on specific molecules involved in cancer cell growth. These treatments are designed to attack cancer cells while limiting damage to healthy cells.

Conclusion:

In conclusion, B-cell lymphomas are diverse cancers with varying growth patterns, symptoms, and treatment needs. Early diagnosis, accurate staging, and personalized treatment plans significantly improve outcomes. Advances in therapies, including chemotherapy, immunotherapy, and targeted treatments, continue to enhance survival and quality of life for patients living with B-cell lymphoma. Moreover, ongoing clinical research studies in Nebraska are exploring potential new treatment options for different types of lymphoma, offering patients access to new treatment possibilities, and contributing to the advancement of lymphoma care.