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Understanding Diffuse Large B Cell Lymphoma (DLBCL)

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Published on July 16, 2020

Diffuse B-Cell lymhoma is a rare, aggressive type of non-Hodgkin lymphoma. The most common symptom of diffuse large B cell lymphoma is enlarged lymph nodes, often in the neck or groin area. Other common symptoms are unexplained fever. chills or loss of appetite and weight loss.
 
Dr. Erlene Seymour from the Karmanos Cancer Institute and Patient Power co-founder, Andrew Schorr discuss what diffuse large B cell lymphoma is and the initial treatments to confirm the diagnosis.
 
This is Part 1 of a 2 part series, watch Part 2 Diffuse Large B-Cell Lymphoma Diagnosis.

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Transcript | Understanding Diffuse Large B Cell Lymphoma (DLBCL)

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Hello and welcome to Patient Power. I'm Andrew Schorr. We're visiting Dr. Erlene Seymour from the Karmanos Cancer Institute in Detroit. And Dr. Seymour is a lymphoma specialist. We're talking about diffuse large B-cell lymphoma, the most common non-Hodgkin's lymphoma of which there are many. Thank you for being with us, Doctor. Let's just understand diffuse large B-cell lymphoma. How is it? What is it?

Dr. Seymour:

Diffuse large B-cell lymphoma is a cancer in your white blood cells. It's a blood cell called a lymphocyte so you've got several different types of white blood cells. And your normal lymphocytes usually fight off infections. When there is a lymphocyte that has a mutation or some kind of injury to its DNA, it can cause that to be cancerous. And so we have several types of lymphomas, diffuse large B-cell lymphoma is the most common type of lymphoma, but there are more than 60 types of lymphomas out there. What's unique about diffuse large B-cell lymphoma is that it's an aggressive type of cancer and although aggressive type of cancer sounds scary, that also means that it is a curative type of cancer and it's very sensitive to chemotherapy.

Andrew Schorr:

So, did a patient do anything to bring it on? I'm sure your patients ask, "What did I do, Doc, to deserve this? Was it a pesticide or something environmental?" I'm sure you're asked these sorts of questions all the time.

Dr. Seymour:

I get asked that question quite often. And honestly we are not, at least today in 2020, we haven't found any kind of familial mutation that causes diffuse large B-cell lymphomas. There certainly could be environmental factors. However, it's really hard to pinpoint that. I do think it is multifactorial in terms of how we acquire a mutation. And if I had to summarize, it really it's just bad luck that most of our patients get diffuse large B-cell lymphoma. Now it is certainly part of aging. Most of the median age of people who get diffuse large B-cell lymphoma are typically older. We know that that is part of it.

Andrew Schorr:

When they come to you or are referred to you, what are the symptoms?

Dr. Seymour:

Most typically someone has felt a large lymph node. I will have a patient who's had a large lymph node in their neck and it's grown quite big or it could be near their groin. Oftentimes patients, if they don't have a lymph node that you can easily feel, they're coming in and they have what we call B symptoms. B symptoms being, they have fevers, they have chills, they've lost their weight and their appetite is gone and they're feeling very sick. But with diffuse large B-cell lymphoma, it tends to grow fast and so the symptoms can occur over weeks, months.

Andrew Schorr:

This lump that people feel in their neck, is that the cancer cells clumped together? Is that what it is?

Dr. Seymour:

It absolutely is. Actually you may have some normal cells there and you may have some cells surrounding it, but when we actually take a biopsy of that node, so there's two ways we do that. Sometimes surgeons will come and take the entire lymph node out or we'll have the interventional radiologists take what we core biopsies. And when they see it under the microscope, they see sheets of lymphoma cells. And that's how we make the diagnosis.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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