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Treating diffuse large B‑cell lymphoma

Treating diffuse large B‑cell lymphoma

Most people with diffuse large B‑cell lymphoma (sometimes called DLBCL for short) are offered chemotherapy with rituximab as their first treatment. This may be followed by radiotherapy. Your care team will discuss treatment options with you.

Stopping the lymphoma from developing in your brain and spinal cord

DLBCL can sometimes develop in the brain and spinal cord. There is more chance of this happening if you have the lymphoma in your testicles, breast, adrenal gland or kidney. To lower this risk, you should be offered an additional type of chemotherapy that can reach the brain.

You should also be offered this treatment if 4 or 5 of the following apply to you:

  • you are over 60

  • you have stage 3 or stage 4 DLBCL

  • your lymphoma is in more than 1 place outside your lymph nodes

  • you can't carry on with your normal daily activities because of your illness

  • you have high blood levels of an enzyme called lactate dehydrogenase (LDH).

If only 2 or 3 of the above apply to you, you might still be offered this treatment – ask your care team for more information.

Check‑ups after your treatment

If your symptoms come back or you get new symptoms, tell your care team straight away – you should be given an urgent appointment.

If you are in complete remission after your first treatment for DLBCL, you should have regular check‑ups for 3 years – after this time your doctor may decide you no longer need them. You don't need regular scans or X‑rays to check for signs of lymphoma if you don't have symptoms.

What if DLBCL comes back after treatment?

If your DLBCL comes back or the first treatment hasn't worked very well, you should be offered high‑dose chemotherapy with rituximab, followed by a stem cell transplant, if you are well enough. This is called 'consolidation' treatment.

Questions you could ask about treating DLBCL

  • What are the chances that DLBCL will spread to my brain?

  • Can you explain more about the type of chemotherapy that will help prevent this? What does it involve?

  • What is rituximab – is it suitable for me?

  • What signs should I look out for that the lymphoma is coming back?

  • If the lymphoma comes back, what options can you suggest?

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