What is B-Cell Lymphoma?

B-Cell Lymphoma is a type of cancer that originates in the white blood cells, which are called lymphocytes. There are two types of lymphocytes, but the B-cell lymphocytes, which aid in the body’s production of antibodies, are the cells that are affected in B-Cell lymphoma. When a person has b-cell lymphoma, the body makes too many abnormal b-cells, which do not do well at fighting infections. These b-cells can spread to other parts of your body.

The lymphatic system carries the lymphocytes throughout the body, specifically to structures in the body that have lymph nodes (armpit, groin, neck). Lymphoma grows in the lymph nodes or any place that has lymph tissue (spleen, bone marrow, thymus, adenoids, tonsils, and stomach). The most common form of b-cell lymphoma is non-Hodgkin’s lymphoma.

Types of B-Cell Lymphomas

B-cell lymphocytes aid in the body’s production of antibodies, which help the body fight infections. With b-cell lymphoma, the body makes too many abnormal b-cells, which are not helpful in fighting off infection. These cells can spread to other parts of your body. 

There are many types of b-cell lymphomas. The most common type of b-cell lymphoma is non-Hodgkin’s lymphoma. The most common type of non-Hodgkin’s lymphoma is diffuse large B-cell lymphoma (DLBCL). Other types of b-cell lymphoma include:

• Follicular lymphoma. This type grows slowly and mostly affects older adults.
• Chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL). These are slow growing types that are closely related.
• Mantle cell lymphoma. A fast-growing lymphoma.
• Marginal zone lymphoma. This type consists of small cells that grow slowly.
• Burkitt lymphoma. This is a rare type that grows quickly.
• Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia). This type of lymphoma is both rare and slow-growing.
• Primary mediastinal large B-cell lymphoma. This type of lymphoma is rare and mostly affects young adults and is more common in women.

Symptoms

As the abnormal b-cells multiply and spread through the lymphatic system, lymph nodes may swell and any areas of the body with lymph tissue may also become enlarged. Other common symptoms of b-cell lymphoma include:

• Fever
• Night sweats
• Fatigue
• Unexplained weight loss
• Difficulties breathing
• Loss of appetite
• Pain or swelling in the abdomen
• Severe itching

Causes

There is no one specific cause for b-cell lymphoma and some people who develop it have no risk factors. Doctors believe that b-cell lymphoma develops due to many factors and variables over time, which change the immune system and make a person more susceptible. Common factors or variables include:

• Environmental factors
• Immune system conditions (auto-immune disorders)
• Chronic infections, such as HIV
• Chronic inflammation

Risk Factors

• Immunosuppression. Conditions that weaken the immune system, such as HIV, leave the body vulnerable to lymphoma and may lead to more aggressive variations of the disease.
• Auto-immune conditions. These conditions occur when the immune system attacks healthy tissue, such as in rheumatoid arthritis. These conditions may cause an elevated risk for developing b-cell lymphoma.
• Infections. Infections, such as the Epstein-Barr virus has been linked to higher rates of b-cell lymphoma.
• Medication. Certain immunosuppressing drugs may increase the risk of developing b-cell lymphoma.
• Chemicals. Certain toxins or pesticides may increase the risk of developing b-cell lymphoma.
• Age. People over the age of 60 are at a higher risk for developing b-cell lymphoma.

Diagnosis

If you have been experiencing symptoms of b-cell lymphoma, it is important to visit your doctor so they can make an appropriate diagnosis. An accurate diagnosis increases the chances for better treatment outcomes. There are several diagnostic methods doctors use to diagnose b-cell lymphoma. Generally, a physical exam will be conducted, and a full medical history will be taken. Specific diagnostic methods include:

• Physical exam. During the exam, a doctor will check for any swelling in the lymph nodes in the neck, underarm, groin, spleen, and liver.
• Blood test and urine sample. These tests will help to rule out any other conditions or diseases.
• Imaging tests. Imaging tests may be recommended to find lymphoma cells elsewhere in your body. Those tests may include an MRI, CT, and positron emission tomography (PET).
• Lymph node test. A lymph node biopsy may be recommended to remove part or all of the lymph node to have it analyzed. The analysis of lymph tissue may be able to determine whether it is non-Hodgkin’s lymphoma and if so, which type. 
• Bone marrow test. This test includes a bone marrow biopsy and aspiration procedure, which requires a needle to be inserted into the hip bone to draw out bone marrow.
• Lumbar puncture (spinal tap). This procedure is recommended when it is suspected that the lymphoma may be impacting your spinal cord fluid. The procedure requires a needle to be inserted into the spinal canal to extract a sample of spinal fluid to be analyzed.

Treatment

There are several forms of treatment for b-cell lymphoma. What treatment option you choose depends on the type of cancer, how advanced it is (the stage), and your overall health and risk factors. Treatment options for b-cell lymphoma include:

• Chemotherapy. Chemotherapy is the use of anti-cancer drugs that are injected into a vein (IV) or taken in pill form. The drugs enter the bloodstream, allowing them to reach almost every part of the body and making it an effective treatment for lymphoma. Chemo is the most common treatment used for people with non-Hodgkin’s lymphoma, and it can be used alone, or combined with other treatment methods (immunotherapy or radiation therapy).
• Immunotherapy. Immunotherapy treatment works to boost the patients’ own immune system by either using their own immune system or using man-made parts (monoclonal antibodies) of the immune system to destroy or slow the growth of the lymphoma cells. Other examples of immunotherapy are immune checkpoint inhibitors, immunomodulating drugs, and chimeric antigen receptor (CAR) T-cell therapy.
• Targeted Drug Therapy. As research has learned more about the changes in lymphoma cells that help them grow, drugs have been developed to specifically target these changes. The targeted drugs work differently than typical chemo drugs. Sometimes these drugs are effective when standard chemo drugs do not work. They also have different side effects. 
• Radiation Therapy. Radiation therapy uses high-energy rays to destroy cancer cells. Radiation can be effective if it is used in the early stages of cancer. It may also be used in combination with chemotherapy in later stages. Additionally, for those getting a stem cell transplant, radiation may be used in combination with chemotherapy. Lastly, radiation may be used to alleviate symptoms when the lymphoma has spread to the internal organs, or when a tumor is causing pain because it’s pressing against a nerve.
• High-Dose Chemotherapy and Stem Cell Transplant. A stem cell transplant, also known as a bone marrow transplant, allows patients to receive a higher dosage of chemo. This is because higher doses of chemo would severely damage the bone marrow, where new blood cells are made. However, with a stem cell transplant, doctors can give higher doses of chemo because the transplant contains blood-forming stem cells that will restore the bone marrow. This type of treatment is usually only used if a patient is in remission or has relapsed during or after treatment.
• Surgery Biopsy. Surgery is usually only used to get a biopsy or sample of the tissue to classify the type of lymphoma. In general, surgery is rarely used as a treatment option for b-cell lymphoma. On rare occasions, surgery may be used if the lymphoma is confined to an organ, such as the spleen, stomach, or thyroid. Otherwise, radiation is the preferred method of treatment over surgery.