Diffuse large B cell lymphoma
- Diffuse large B cell lymphoma
Infobox_Disease
Name = Diffuse large B cell lymphoma
Caption =
DiseasesDB =
ICD10 =
ICD9 =
ICDO = 9680/3
OMIM =
MedlinePlus =
eMedicineSubj =
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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. [ [http://www.utdol.com/utd/content/topic.do?topicKey=lymphoma/20525] "Pathobiology of the aggressive and highly aggressive non-Hodgkin's lymphomas"] Of all cancers involving the same class of blood cell, 31% of cases are DFBL.[cite book]
author=Turgeon, Mary Louise
title=Clinical hematology: theory and procedures
publisher=Lippincott Williams & Wilkins
location=Hagerstown, MD
year=2005
pages=283
isbn=0-7817-5007-5
quote=Frequency of lymphoid neoplasms. (Source: Modified from WHO Blue Book on Tumour of Hematopoietic and Lymphoid Tissues. 2001, p. 2001.)]
Classification
Two major subtypes of DFBL have been identified based on their genetic activity:[cite book]
author=Turgeon, Mary Louise
title=Clinical hematology: theory and procedures
publisher=Lippincott Williams & Wilkins
location=Hagerstown, MD
year=2005
pages=285-286
isbn=0-7817-5007-5]
* "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: [ [http://atlasgeneticsoncology.org/Anomalies/DLCLID2076.html "Diffuse large cell lymphoma"] at "Atlas of Genetics and Cytogenetics in Oncology and Haematology"]
* 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.
Prognosis
The germinal center subtype has the best prognosis, with 60% of treated patients surviving more than five years.
References
Wikimedia Foundation.
2010.
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