B-cell lymphomas comprise both Hodgkin lymphomas (HLs) and the majority of non-Hodgkin lymphomas (NHLs) (80-85%). Developing from B-cells and affecting the lymphatic system, B-cell lymphomas may be indolent or aggressive. Most B-cell lymphomas are NHLs, which include diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, mantle cell lymphoma (MCL) and Burkitt’s lymphoma.
Diagnosis can be determined via a bone marrow/lymph node biopsy and examination, with or without flow cytometry and immunohistochemical staining of the biopsied specimens. In addition, chromosomal analysis can be performed to detect common rearrangements, such as the t(14;18)(q32;q21) translocation of IGH/BCL2. An exciting upcoming development in this area is liquid biopsies, analyzing circulating tumor cells (CTCs) and cell-free tumor DNA (ctDNA) in the blood, which could be used for noninvasive diagnosis and disease monitoring.
Knowing the origin of the lymphoma is essential to determine the optimal course of treatment and the prognosis. The typical treatment for B-cell lymphomas includes radiotherapy, chemotherapy and targeted agents. However, the treatment is usually tailored to the type of lymphoma, as well as the stage of the disease. For example, DLBCL can be treated with rituximab and cyclophosphamide, hydroxydaunorubicin, vincristine, prednisone, and bleomycin (R-CHOP), while follicular lymphoma is usually treated with alkylating agents and rituximab. These treatments may soon change, as this is a fast-paced, exciting time for lymphoma research, with numerous novel drugs and therapeutic combinations being tested in clinical trials.