Ability to Identify Genetic Type of Lymphoma Can Lead to Better Treatment Accuracy

In a recently published study, researchers identified genetic subtypes of diffuse large B-cell lymphoma (DLBCL) that could help to explain why some patients with the disease respond positively to treatment and others do not.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL) in the United States and worldwide, accounting for up to one-third of patients with newly diagnosed NHL in the United States.

Diffuse large B-cell lymphoma is an aggressive (fast-growing) non-Hodgkin lymphoma that affects B-lymphocytes. Lymphocytes are one type of white blood cell, carried along by lymph fluid and are a part of the immune system. B-cells are lymphocytes that make antibodies to fight infections and are an integral part of the lymphatic system—the channels, tissues and organs that store and carry lymphocytes that fight infection and other diseases.

Although it can occur in childhood, the occurrence of diffuse large B-cell lymphoma generally increases with age, and most patients are over the age of 60 at diagnosis.

DLBCL can develop in the lymph nodes—small bean-shaped glands located in the small vessels of the lymphatic system. There are thousands of lymph nodes located throughout the body, with clusters of them in the neck, under the arms, the chest, abdomen and groin. Lymph nodes filter lymph fluid, trapping and destroying potentially harmful bacteria and viruses—or in “extranodal sites” (areas outside the lymph nodes) such as the gastrointestinal tract, reproductive organs, thyroid, breast, bone, brain or essentially any organ of the body. It can be localized (in one spot) or generalized (spread throughout the body). Despite being an especially aggressive form of lymphoma, diffuse large B-cell lymphoma is considered potentially curable.

A recent study examined pre-existing information to come to new conclusions

The recently published study in the New England Journal of Medicine, combined studies by researchers in the Center for Cancer Research (CCR) at the National Cancer Institute (NCI), a part of the National Institutes of Health with additional researchers from around the world.

"These findings are the culmination of two decades of research at NCI and elsewhere, advancing our understanding of the effect of DNA mutations and gene expression on lymphoma biology and outcome," said NCI Director Ned Sharpless, M.D. "This refined molecular classification will be instrumental in predicting prognosis and tailoring therapy for patients with DLBCL going forward."

Figuring out why certain drugs work for some people and not for others

Diffuse large B-cell lymphoma is the most common type of lymphoma.  Although it can be aggressive, it is potentially curable, and in some patients, treatment eliminates the disease.  However, researchers still don't have a full understanding of why some lymphomas of this type respond to treatment and others don't.  The standard treatment for the disease is a combination of chemotherapy drugs plus rituximab, a drug known as a monoclonal antibody.