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Sunday, April 8, 2018

Promising Personalized Therapeutic Options for Diffuse Large B ...
src: clincancerres.aacrjournals.org

The B-cell lymphomas are types of lymphoma affecting B cells. Lymphomas are "blood cancers" in the lymph nodes. They develop more frequently in older adults and in immunocompromised individuals.

B-cell lymphomas include both Hodgkin's lymphomas and most non-Hodgkin lymphomas. They are typically divided into low and high grade, typically corresponding to indolent (slow-growing) lymphomas and aggressive lymphomas, respectively. As a generalisation, indolent lymphomas respond to treatment and are kept under control (in remission) with long-term survival of many years, but are not cured. Aggressive lymphomas usually require intensive treatments, with some having a good prospect for a permanent cure.

Prognosis and treatment depends on the specific type of lymphoma as well as the stage and grade. Treatment includes radiation and chemotherapy. Early-stage indolent B-cell lymphomas can often be treated with radiation alone, with long-term non-recurrence. Early-stage aggressive disease is treated with chemotherapy and often radiation, with a 70-90% cure rate. Late-stage indolent lymphomas are sometimes left untreated and monitored until they progress. Late-stage aggressive disease is treated with chemotherapy, with cure rates of over 70%.


Video B-cell lymphoma



Types

There are numerous kinds of lymphomas involving B cells. The most commonly used classification system is the WHO classification, a convergence of more than one, older classification systems.

Common

Five account for nearly three out of four patients with non-Hodgkin lymphoma:

  • Diffuse large B-cell lymphoma (DLBCL)
  • Follicular lymphoma
  • Marginal zone B-cell lymphoma (MZL) or Mucosa-Associated Lymphatic Tissue lymphoma (MALT)
  • Small lymphocytic lymphoma (also known as chronic lymphocytic leukemia, CLL)
  • Mantle cell lymphoma (MCL)

Rare

The remaining forms are much less common:

  • DLBCL variants or sub-types of
    • Primary mediastinal (thymic) large B cell lymphoma
    • T cell/histiocyte-rich large B-cell lymphoma
    • Primary cutaneous diffuse large B-cell lymphoma, leg type (Primary cutaneous DLBCL, leg type)
    • EBV positive diffuse large B-cell lymphoma of the elderly
    • Diffuse large B-cell lymphoma associated with inflammation
  • Burkitt's lymphoma
  • Lymphoplasmacytic lymphoma, which may manifest as Waldenström's macroglobulinemia
  • Nodal marginal zone B cell lymphoma (NMZL)
  • Splenic marginal zone lymphoma (SMZL)
  • Intravascular large B-cell lymphoma
  • Primary effusion lymphoma
  • Lymphomatoid granulomatosis
  • Primary central nervous system lymphoma
  • ALK-positive large B-cell lymphoma
  • Plasmablastic lymphoma
  • Large B-cell lymphoma arising in HHV8-associated multicentric Castleman's disease
  • B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma
  • B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma

Other

Additionally, some researchers separate out lymphomas that appear to result from other immune system disorders, such as AIDS-related lymphoma.

Classic Hodgkin's lymphoma and nodular lymphocyte predominant Hodgkin's lymphoma are now considered forms of B-cell lymphoma.


Maps B-cell lymphoma



Associated chromosomal translocations

Chromosomal translocations involving the immunoglobulin heavy locus (IGH@) is a classic cytogenetic abnormality for many B-cell lymphomas, including follicular lymphoma, mantle cell lymphoma and Burkitt's lymphoma. In these cases, the immunoglobulin heavy locus forms a fusion protein with another protein that has pro-proliferative or anti-apoptotic abilities. The enhancer element of the immunoglobulin heavy locus, which normally functions to make B cells produce massive production of antibodies, now induces massive transcription of the fusion protein, resulting in excessive pro-proliferative or anti-apoptotic effects on the B cells containing the fusion protein.

In Burkitt's lymphoma and mantle cell lymphoma, the other protein in the fusion is c-myc (on chromosome 8) and cyclin D1 (on chromosome 11), respectively, which gives the fusion protein pro-proliferative ability. In follicular lymphoma, the fused protein is Bcl-2 (on chromosome 18), which gives the fusion protein anti-apoptotic abilities.


Diffuse large B-cell lymphoma - Wikipedia
src: upload.wikimedia.org


See also

  • Richter's transformation
  • T-cell lymphoma

Diffuse large B-cell lymphoma in leukemic phase | Blood Journal
src: www.bloodjournal.org


References


Nodal aggressive B-cell lymphomas: a diagnostic approach | Journal ...
src: jcp.bmj.com


External links

  • Overview and video at harvard.edu
  • Lymphoma Association - Specialist UK charity providing free information and support to patients, their families, friends and carers

Source of article : Wikipedia