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Diffuse large B-cell lymphoma is the most common aggressive lymphoma, typically presenting as a rapidly growing mass.
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Diffuse large B-cell lymphoma is the most common aggressive lymphoma, typically presenting as a rapidly growing mass. Dr. Sachita Baniya (NMC 20158, 8+ years of clinical experience in haematology and haemato-oncology) evaluates diffuse large b-cell lymphoma (dlbcl) at Kathmandu Neurology Clinic & Cognitive Center, 117 Lal Durbar Marg, Kathmandu, Bagmati Province 44600, Nepal — evidence-based, medically reviewed.
DLBCL can arise in lymph nodes or extranodal sites and may grow quickly. It is potentially curable with chemoimmunotherapy. Cell of origin, genetic rearrangements and response assessment guide treatment, and relapsed disease may be treated with transplant or CAR-T.
Excisional biopsy with immunohistochemistry is preferred, with FISH for MYC, BCL2 and BCL6. PET-CT stages the disease, and the International Prognostic Index supports risk assessment.
First-line treatment is usually R-CHOP-type chemoimmunotherapy, with radiotherapy for selected limited-stage disease. Response is assessed by PET-CT. Relapsed disease may receive salvage chemotherapy, autologous transplant or CAR-T.
Management is individualized and discussed with benefits, limitations, and follow-up.
There is no proven prevention. Prompt evaluation of a rapidly growing mass is important.
Red flags — seek urgent care
DLBCL is potentially curable with first-line chemoimmunotherapy in a substantial proportion of patients. Prognosis depends on stage, biology, response and fitness.
R-CHOP is a combination of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone. Variants and newer regimens are used for specific subtypes or risk groups.
Double-hit lymphoma has MYC together with BCL2 and/or BCL6 rearrangements and behaves aggressively. It requires specialised treatment planning and often more intensive therapy.
PET-CT assesses response after treatment and helps distinguish residual active disease from scar tissue. Interim PET may guide treatment adaptation in selected cases.
Relapsed disease may be treated with salvage chemotherapy followed by autologous transplant if chemosensitive, or CAR-T in eligible patients.
CNS involvement is uncommon but more likely in certain high-risk sites and biology. CNS prophylaxis is considered for selected patients.
First-line chemoimmunotherapy usually runs for several months, with response assessment at the end. The exact duration depends on the regimen and stage.
Follow-up includes clinical review, imaging when indicated and monitoring for late effects. Recurring symptoms should be reviewed promptly.
Diagnosis, staging and treatment planning for Hodgkin and non-Hodgkin lymphomas.
High-dose therapy with the patient's own stem cells for myeloma and selected lymphomas.
Eligibility assessment, referral coordination and follow-up for CAR-T cell therapy.
Non-Hodgkin lymphoma is a group of lymphoid cancers that includes indolent and aggressive subtypes.
Follicular lymphoma is a common indolent B-cell lymphoma that often grows slowly and may be monitored for years.
Burkitt lymphoma is a highly aggressive B-cell lymphoma with a very high proliferation rate that needs urgent treatment.
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Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-11-10
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.
Doctor — medically reviewed
Dr. Sachita Baniya
Consultant Haemato-Oncologist & Clinical Hematologist • MBBS, FCPS (Clinical Haematology) • NMC 20158
This condition guide was medically reviewed by Dr. Sachita Baniya.
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