Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma, resulting in more than 18,000 cases in the United States every year, or more than 20 percent of all B-cell non-Hodgkin’s lymphomas. Lymphoma is cancer of the lymphatic system, which helps rid the body of toxins and waste. Lymphoma is divided into Hodgkin’s lymphoma and non-Hodgkin’s lymphoma, where the only difference is the presence of Reed-Sternberg cells that can be seen under a microscope. In non-Hodgkin’s lymphoma, the cells are not present. Non-Hodgkin’s lymphomas are categorized as B-cell or T-cell depending on whether the cancer started in B lymphocytes or T lymphocytes, which are the two types of white blood cells in the lymphatic system.
The further throughout the body the cancer spreads, the later the stage of lymphoma. Diffuse large B-cell lymphoma stage 4 is the most advanced stage of DLBCL, where treatment options are often limited, and the survival rate is lower. The stages of DLBCL can be defined as:
- Stage 1: The cancer has not spread outside the original lymph node area, lymph structure or lymphoid organ.
- Stage 2: Two or more lymph node groups are affected on the same side of the diaphragm, which separates the chest and the abdomen.
- Stage 3: Two or more lymph node groups are affected on different sides of the diaphragm.
- Stage 4: The cancer has spread to surrounding organs or tissues such as the lungs, liver, or bone marrow.
Stage 4 Diffuse Large B-Cell Lymphoma Symptoms
The first sign of DLBCL in most patients is a lump located on the neck, groin, or near the armpit. If the lymphoma develops deep enough under the skin, you may not be able to feel the lump. Extranodal disease affects 20% of DLBCL patients and occurs when the cancer develops outside the lymph nodes in areas such as the breast tissue, GI tract, skin, brain, or bones. These painless lumps are swollen lymph nodes that steadily grow for several weeks. Other symptoms experienced depend on where the cancer is in the body. When in the stomach, abdominal pain, blood in the stool, or diarrhea are common. If in the chest, patients often have a cough that won’t go away and shortness of breath. If you experience any of the common symptoms associated with DLBCL, it is important to go talk to your doctor to confirm a diagnosis and begin treatment as necessary.
Diffuse large b-cell lymphoma stage 4a refers to patients with DLBCL that do not experience any symptoms related to the disease. DLBCL with a “b” in the stage indicates that the patient is experiencing one or more of the B symptoms, which are common and include:
- Persistent fatigue
- Bloating from an enlarged spleen or liver
- Night sweats
- Itchy skin
- Unexplained lack of appetite leading to weight loss
Survival Rate Stage 4 Diffuse Large B-Cell Lymphoma
Stage 4 diffuse large b-cell lymphoma survival rate mostly depends on two factors, where the cancer is located and whether it has spread throughout the body. The Surveillance, Epidemiology, and End Results (SEER) database, which was National Cancer Institute (NCI), combines these factors to track the survival rates of lymphomas and other cancer types. Instead of stage 1,2, 3, or 4, the lymphoma survival rates are classified by localized, regional, or distant to more accurately define the rate of survival.
Localized cancer is only in one organ outside the lymph system, one lymph node area, or lymphoid organ. Regional lymphoma has spread from one lymph node area to an organ, in at least two lymphoid areas, or is defined as a bulky disease (large lumps) by your doctor. Distant lymphoma has spread to different organs or parts of the body, usually the liver, lungs, or bone marrow.
Diffuse large b cell lymphoma stage 4 survival rate for 5 years by stage according to SEER:
- Localized: 73%
- Regional: 73%
- Distant: 57%
- All SEER stages combined: 64%
Diffuse Large B-Cell Lymphoma Stage 4 Prognosis
Diffuse Large b-cell lymphoma stage 4 prognosis depends on several factors such as age, stage of disease, overall health, and extent of the spread of cancer throughout the body. The more negative factors that are present, the lower the survival rate will be. Because symptoms are not always felt until in advanced stages, early detection of DLBCL is not common. Also, DLBCL is an aggressive subtype of non-Hodgkin’s lymphoma that grows and spreads faster than indolent lymphomas which grow slowly over several years. However, nearly 70% of all patients with this subtype will have successful treatment. The earlier the cancer is detected and treated, the more likely it is that the disease will be curable.
Clinical Trials for Large B-Cell Lymphoma
Diffuse large B-cell lymphoma clinical trials offer new studies for patients before they are widely available while the drugs go through the FDA approval process. There are over 800 clinical trials active in the United States for lymphoma. Participating in a clinical trial not only progresses much needed research but gives patients access to these innovative therapies years before the general population.
Current lymphoma clinical trials are researching new:
- Targeted therapies for new biomarkers
- Combinations of chemotherapies with other drugs
- Immunotherapy drugs, such as CAR T-cell therapy
- Idiotypic vaccination
Massive Bio’s Artificial Intelligence (AI) powered Clinical Trial Matching System connects patients and their treating oncologists to clinical trials according to their unique cancer case.