If you’ve been diagnosed with lymphoma, some of your white blood cells, called lymphocytes, have become abnormal. You may have heard of blood cancers or lymphomas, but are you aware that all blood cancers are not the same? Lymphomas are categorized based on which cells within the immune system are affected, and whether the cancer is slow-growing or aggressive.1,2
What is the Immune System?3
Your immune system protects your body from germs, viruses, cell changes, and harmful substances that can make you sick.
When your body comes in contact with something it doesn’t recognize as its own (invaders like bacteria or viruses), it triggers your immune system which consists of the innate and adaptive immune systems.
Your innate immune system is your body’s first line of defense including your skin, other physical barriers (i.e. mucous membranes), and special cells (e.g., natural killer cells, and phagocytes) that attack harmful substances and provide general defense against foreign substances. After your body has fought these substances, it creates antibodies to “remember” them.
Your adaptive immune system is specific and it specializes in fighting certain germs and harmful substances that your body has previously encountered. When one of those invaders returns, antibodies created to target these specific foreign substances are released.
What is Diffuse Large B-cell Lymphoma?
Diffuse large B-cell lymphoma (DLBCL) is a fast-growing, aggressive subtype of non-Hodgkin lymphoma (NHL). Lymphomas are cancers that affect your white blood cells. These blood cancers directly affect your blood cells and weaken your immune system (the germ-fighting system in your body). There are at least 60 different types of NHL and DLBCL is the most common type of NHL.4
B-cell lymphomas like DLBCL develop in the B cells of the immune system. B-cells are white blood cells that protect you from infection. B-cells are important because they travel through the blood and lymphatic system to attack foreign invaders like viruses and bacteria (plasma cells). They also remember those cells so they can fight back faster in the future (memory cells).5-8
Signs and Symptoms of Diffuse Large B-cell Lymphoma4,9
A rapidly growing, painless mass that typically appears as an enlarged lymph node is often the first sign of DLBCL. The mass may appear in the neck, groin, or abdomen.4
Other symptoms may include:
- Weight loss without trying (at least 10% of body weight over 6 months)
- Drenching night sweats
- Fever (which can come and go over several days or weeks) without an infection
- Fatigue
- Chest pain or pressure
- Shortness of breath or cough
- Easy bruising or bleeding
- Feeling full after only a small amount of food
Not all individuals with NHL will experience these symptoms. If you are persistently experiencing any of these symptoms, consult your doctor.
Diffuse Large B-cell Lymphoma and the Immune System
There are many links between diffuse large B-cell lymphoma (DLBCL) and the immune system. Some autoimmune diseases, infections, and immune deficiency syndromes (such as HIV or AIDS) can contribute to the development of DLBCL.10 An imbalance in the immune system is closely related to the development and progression of B-cell lymphomas.
DLBCL can lead to immune dysfunction. DLBCL decreases normal B cells and normal communication between B cells and other immune cells.10 This type of cancer also decreases the number and function of another type of immune cell called a T cell.10,11
T cells also protect you from infection. They direct your body’s immune response by helping B cells. The decrease in normal B cells and T cells puts you at a greater risk of developing infections.12
Even after cancer treatment, elderly people who had DLBCL may have an increased infectious risk for years. One study looked at 21,690 survivors of DLBCL and found that they had an increased risk for infections for 5-10 years after their initial cancer diagnosis. The researchers observed increased risks of pneumonia, meningitis, and a rare condition where the immune system attacks healthy blood cells.
T-cells in the immune system are also required to prevent and control B-cell cancers.11 An impaired immune system can lead to the development of lymphoma, and B-cell lymphomas further suppress the immune system to promote its progression.
References
- Lymphoma Research Foundation. (2024). About Lymphoma and Lymphoma subtypes https://lymphoma.org/understanding-lymphoma/aboutlymphoma/ Accessed September 24, 2024
- Lymphoma Research Foundation. (2024). Understanding Non Hodgkin Lymphoma https://lymphoma.org/wp-content/uploads/2023/10/LRF_Understanding_Lymphoma_Non_Hodgkin_Lymphoma_Lymphoid_Neoplasms_Fact_Sheet.pdf Accessed September 24, 2024
- Institute for Quality and Efficiency in Health Care (IQWiG). (2023). “In brief: how does the immune system work?” https://www.ncbi.nlm.nih.gov/books/NBK279364/ Accessed October 3, 2024
- Up To Date. (2024). Patient education: Diffuse large B cell lymphoma in adults (Beyond the Basics) https://www.uptodate.com/contents/diffuse-large-b-cell-lymphoma-in-adults-beyond-the-basics/print Accessed September 24, 2024
- The University of Texas MD Anderson Cancer Center. (2024). B-cell lymphoma https://www.mdanderson.org/cancer-types/non-hodgkin-lymphoma/b-cell-lymphoma.html Accessed September 24, 2024
- The Cleveland Clinic. (2023). B-Cells https://my.clevelandclinic.org/health/body/24669-b-cells Accessed September 24, 2024
- National Cancer Institute. (2024). B-cell lymphoma https://www.cancer.gov/publications/dictionaries/cancer-terms/def/b-cell-lymphoma Accessed September 24, 2024
- American Cancer Society. (2024). Types of B-cell Lymphoma https://www.cancer.org/cancer/types/non-hodgkin-lymphoma/about/b-cell-lymphoma.html Accessed September 24, 2024
- American Cancer Society. (2024) Signs and Symptoms of Non-Hodgkin Lymphoma https://www.cancer.org/cancer/types/non-hodgkin-lymphoma/detection-diagnosis-staging/signs-symptoms.html Accessed September 25, 2024
- Mancuso, Salvatrice et al. (2022). Effects of B-Cell Lymphoma on the Immune System and Immune Recovery after Treatment: The Paradigm of Targeted Therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8952275/ Accessed September 25, 2024
- Roufaiel Marian NKN et al. (2015) Impaired T-Cell Function in B-Cell Lymphoma: A Direct Consequence of Events at the Immunological Synapse? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4451642/ Accessed September 25, 2024
- The University of Texas MD Anderson Cancer Center. (2021). T cells, B cells and the immune system https://www.mdanderson.org/cancerwise/t-cells–b-cells-and-the-immune-system Accessed September 25, 2024
You Might Also Like:
Dr. Marsh Answers Your Cancer Questions
We sat down with Dr. Patricia Kelly Marsh, CEO and co-founder of Ask Me Your MD, to get the real talk on some common cancer questions.
Preparing for Hair Loss During Lymphoma Treatment
Learn about which lymphoma treatments cause hair loss and what you can do to prepare for this change.
