Diffuse large B cell lymphoma
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Diffuse large B-cell lymphoma (DFBL) is a type of aggressive lymphoma. It accounts for approximately 40% of lymphomas among adults.^[1] Of all cancers involving the same class of blood cell, 31% of cases are DFBL.^[2]

Classification

Two major subtypes of DFBL have been identified based on their genetic activity:^[3]

• activated, with a pattern of genetic expression that is similar to healthy, activated B cells, and
• germinal center, with a pattern of genetic expression that is similar to germinal center B cells and a chromosomal translocation involving the gene bcl-2.

The remaining cases of DFBL are sometimes called "type 3," although they are unrelated to each other.

Chromosome anomalies are:^[4]

• t(14;18)(q32;q21) with BCL2-rearrangement,
• t(3;Var)(q27;Var) with BCL6-rearrangement,
• t(8;14)(q24;q32) with MYC rearrangements,
• and other less characteristic anomalies.

Treatment

Standard treatment is CHOP. An expanded protocol, called CHOP-R, has improved survival and rates of complete responses for DFBL patients, particularly elderly patients.^[3]

Prognosis

The germinal center subtype has the best prognosis, with 60% of treated patients surviving more than five years.^[3]

References

1. ^ [1] Pathobiology of the aggressive and highly aggressive non-Hodgkin's lymphomas
2. ^ Turgeon, Mary Louise (2005). Clinical hematology: theory and procedures. Hagerstown, MD: Lippincott Williams & Wilkins, 283. ISBN 0-7817-5007-5. "Frequency of lymphoid neoplasms. (Source: Modified from WHO Blue Book on Tumour of Hematopoietic and Lymphoid Tissues. 2001, p. 2001.)" 
3. ^ ^{a b c} Turgeon, Mary Louise (2005). Clinical hematology: theory and procedures. Hagerstown, MD: Lippincott Williams & Wilkins, 285-286. ISBN 0-7817-5007-5. 
4. ^ "Diffuse large cell lymphoma" at Atlas of Genetics and Cytogenetics in Oncology and Haematology

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