Did you know that cancers don’t only start within organs? Some cancer types are blood cancers. They directly affect your immune system (or the germ-fighting system in your body) and your blood cells. Lymphoma is a type of blood cancer that affects the white blood cells called lymphocytes, found in the lymphatic system.
Lymphomas are broken down into two main types: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Read our Lymphoma 101 article for greater detail on HL and NHL.
If you’ve been diagnosed with lymphoma, it means that some of your white blood cells, called lymphocytes have become abnormal. These changes to your cells make them duplicate faster than normal and can lead to unusual growth. This rapid growth occurring within your blood and lymphatic system can cause the cancerous cells to spread throughout your body. Lymphomas are the most common type of blood cancer.1
Lymphomas can be slow-growing or aggressive. The amount of time you are estimated to live after diagnosis and the types of treatment available are based on the type of lymphoma you have and how much the cancer has spread throughout your body.2
There are various types of lymphomas that originate from B-cells including those that are classified as: Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL). 3-6
There are two main categories of NHL, B-cell lymphomas and natural killer/T-cell lymphomas. B-cell lymphomas, which are the most common type, account for 85% of all NHLs.10-12
What is B-Cell Lymphoma? 4-12
B-cell lymphoma is the most common type of lymphoma. It’s a type of blood cancer that develops in the B-cells of the immune system.3-6 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).3-6
B-cell NHL is classified further based on how much the cancer has spread when it is diagnosed, called staging (Stage I, II, III, or IV) and also whether it is aggressive or indolent (slow-growing).
Here are some of the names of aggressive B-cell NHL and indolent (slow-growing) NHL. We won’t go into details on each type, but it’s good for you to be familiar with the names in case you are diagnosed with a particular type. You will have a greater understanding on whether or not your cancer type is aggressive. It’s also a good idea for you to ask your physician what stage of cancer you have and whether or not it is aggressive or slow-growing.
Types of B-cell NHL based on rapid (aggressive) or slow (indolent) growth
Image created by Lymphoma Research Foundation
Let’s take a closer look at these types of B-cell NHL, including diffuse large B-cell lymphoma, which is common and mantle cell lymphoma, which is rare.
Diffuse Large B-cell Lymphoma (DLBCL)
Diffuse large B-cell lymphoma (DLBCL) is the most common type of NHL and makes up about 30% of lymphomas in the United States.6
DBLCL mostly occurs in older people with the average person getting diagnosed around age 65. It is a rapidly growing cancer that can start anywhere in the body but usually starts in a lymph node. The lymph node can be deep in the chest or abdomen where you cannot feel the mass or in a lymph node you can feel such as the neck or armpit.
Although DLBCL is an aggressive (rapid-growing) lymphoma, it is highly treatable. After the initial treatment, about 75% of people will show no signs of the cancer. For others, the cancer is completely cleared.6
Follicular Lymphoma
20% of the lymphomas in the United States are follicular lymphomas. Most are indolent (slow-growing) lymphomas although some lymphomas can be rapid-growing.
Follicular lymphomas are usually seen in people around age 60. Similarly to DLBCL, follicular lymphomas are highly treatable. These cancers, however, are difficult to cure. If you are diagnosed with a follicular lymphoma, your doctor may choose to wait until you have symptoms before starting treatment.6
Chronic Lymphocytic Leukemia / Small Lymphocytic Lymphoma (CLL/SLL)
Chronic lymphocytic leukemia and small lymphocytic lymphoma are the same disease that affects lymphocytes. They are named based on the location where the cancer occurs. In CLL, most of the cancer cells are located in the bloodstream and bone marrow, whereas in SLL, most of the cancer cells are located in the lymph nodes.6,13 CLL/SLL are considered slow growing types of Non-Hodgkin lymphomas. We will discuss this more later.
Many people with CLL/SLL don’t have any symptoms. If you don’t have symptoms, your doctor may accidentally discover this type of cancer during your routine physical exam or bloodwork.6,13
If you do have symptoms, you may experience tiredness, shortness of breath, night sweats, anemia, bruising easily, weight loss, and infections more often.6,13
Because it’s common for people with CLL or SLL not to have symptoms, your doctor may not immediately start treatment after you’re diagnosed. They will treat your cancer based on how severe your symptoms are. If you don’t have any symptoms, your doctor may decide to “watch and wait”.6,13
With the watch and wait treatment strategy, they don’t just send you home to ignore you. You’ll still be closely monitored through regular checkups and tested to see if you have symptoms or if the disease has progressed.
If you start to have symptoms or the disease progresses, your doctor will start you on treatments. Common treatment options for CLL/SLL include single or combination chemotherapy.
Mantle Cell Lymphoma (MCL)
Mantle cell lymphoma (MCL) is a rare, aggressive type of B-Cell NHL that accounts for about 5% of all B-cell NHLs.10 Mantle cell lymphoma is typically diagnosed at a later state of the disease and involves the digestive tract and bone marrow. MCL is most often seen in white men over the age of 60.11 In the beginning stages of the disease it can be slow-growing (indolent) and become more aggressive (fast-growing) over time.6,14-15
Although MCL mostly affects older white men, Black people who develop MCL are more likely to be female, be diagnosed at a younger age, have at least one other serious disease, and be uninsured compared to white people diagnosed with MCL. Black people with MCL are also less likely to receive stem cells transplants compared to white people with MCL.6,14-15
For those people without symptoms, the “watch and wait” approach may be taken for NHLs. If the cancer is spreading or symptoms appear, there are several treatment options available. The most common treatment categories used in NHL are chemotherapy, immunotherapy, targeted therapies, radiation therapy, stem cell transplants, or a combination of these.
References
- Lymphoma Research Foundation (2024) About Lymphoma and Lymphoma subtypes https://lymphoma.org/understanding-lymphoma/aboutlymphoma/
- 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
- 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
- The Cleveland Clinic (2023) B-Cells https://my.clevelandclinic.org/health/body/24669-b-cells
- National Cancer Institute (2024) B-cell lymphoma https://www.cancer.gov/publications/dictionaries/cancer-terms/def/b-cell-lymphoma
- American Cancer Society (2024) Types of B-cell Lymphoma https://www.cancer.org/cancer/types/non-hodgkin-lymphoma/about/b-cell-lymphoma.html
- American Cancer Society (2024) What is Hodgkin Lymphoma https://www.cancer.org/cancer/types/hodgkin-lymphoma/about/what-is-hodgkin-disease.html
- Leukemia and Lymphoma Society (2024) Hodgkin lymphoma https://www.lls.org/lymphoma/hodgkin-lymphoma
- Lymphoma Research Foundation (2024) Hodgkin Lymphoma https://lymphoma.org/understanding-lymphoma/aboutlymphoma/hl/
- Lymphoma Research Foundation (2024) Non-Hodgkin lymphoma https://lymphoma.org/understanding-lymphoma/aboutlymphoma/nhl/
- Yale Medicine (2024) Non-Hodgkin’s Lymphoma https://www.yalemedicine.org/conditions/non-hodgkins-lymphoma
- American Cancer Society (2024) Non Hodgkin lymphoma https://www.cancer.org/cancer/types/non-hodgkin-lymphoma.html
- Lymphoma Research Foundation (2024) Chronic Lymphocytic Leukemia/small Lymphocytic Lymphoma https://lymphoma.org/understanding-lymphoma/aboutlymphoma/cll/
- Varell V et al. (2023) Real World Outcomes of Black Americans with Mantle Cell Lymphoma https://ashpublications.org/blood/article/142/Supplement%201/4412/503454/Real-World-Outcomes-of-Black-Americans-with-Mantle
- Lymphoma Research Foundation (2024) Understanding Lymphoma: Mantle Cell Lymphoma https://lymphoma.org/wp-content/uploads/2023/10/LRF_Understanding_Lymphoma_Mantle_Cell_Lymphoma_Fact_Sheet.pdf
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