June 29, 2022

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Mark Hoppus was diagnosed with diffuse large B-cell lymphoma: What is this disease?

Mark Hoppus was diagnosed with diffuse large B-cell lymphoma: What is this disease?



 

Mark Hoppus was diagnosed with diffuse large B-cell lymphoma: What is this disease?

Mark Hoppus confessed that he was diagnosed with stage 4 diffuse large B-cell lymphoma in April 2022.  

It’s the first time for most people to hear about Diffuse Large B-Cell Lymphoma. What is it?  This article will give you the brief information about it.

 

Mark Hoppus was diagnosed with diffuse large B-cell lymphoma: What is this disease?

snapshot from youtube

 

 

Diffuse large B-cell lymphoma

 

Diffuse large B-cell lymphoma is the most common type of NHL, accounting for almost one-third of all cases. This type of lymphoma accounts for the majority of previously clinically “aggressive” or “moderately high-grade” lymphomas.

The correct diagnosis of diffuse large B-cell lymphoma requires a hemopathologist based on evidence of appropriate biopsy and B-cell immunophenotype.

In recent years, the research data of many international multi-center randomized controlled clinical trials have proved that the standard first-line treatment regimen should be Rituximab (R) + CHOP regimen, and by increasing the dose density of the regimen, shortening the interval time between courses of treatment, so Get better efficacy, such as the R-CHOP14 regimen.
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Diagnosis

The correct diagnosis of diffuse large B-cell lymphoma requires a hemopathologist based on evidence of appropriate biopsy and B-cell immunophenotype.

Patients with prominent mediastinal invasion are sometimes diagnosed with a separate subtype called primary mediastinal diffuse large B-cell lymphoma , which arises in the anterior mediastinum, may originate in the thymus, and usually has prominent interstitial fibers interval, the median age of these patients was younger (37 years), and women were more prevalent (66%).


Diffuse large B-cell lymphoma can begin in primary nodal or primary extranodal disease. More than 50% of patients have extranodal involvement at diagnosis.

The most common extranodal lesions are the gastrointestinal tract and bone marrow, each accounting for 15 to 20% of patients.

Any organ can be involved, and a diagnostic biopsy is necessary.

Diffuse large B-cell lymphoma of the pancreas, for example, has a much better prognosis than pancreatic cancer , but a missed opportunity without biopsy. The incidence of primary brain diffuse large B-cell lymphoma has increased in recent years.

 


Treatment


In recent years, the research data of many international multi-center randomized controlled clinical trials have proved that the standard first-line treatment regimen should be Rituximab (R) + CHOP regimen, and by increasing the dose density of the regimen and shortening the interval time between courses of treatment, so Obtain better efficacy, such as the R-CHOP14 regimen. R-EPOCH can also be used as a first-line treatment option.

Alternative second-line treatment options include DHAP, ESHAP, GDP, ICE, miniBEAM, and MINE. For untreated patients with obvious adverse prognostic factors (international prognostic index IPI intermediate-high-risk and high-risk groups), high-dose chemoradiation combined with autologous peripheral blood stem cell transplantation after induction chemotherapy can significantly improve their long-term disease-free survival and overall survival.

For relapsed patients, transplantation salvage can achieve better results than conventional chemotherapy salvage therapy.

 

 


Prognosis

Gene expression profiling results: The gene expression profiling analysis of more than 1000 genes using gene chip technology in collaboration between Stanford University and the American Cancer Institute shows that DLBCL contains three different molecular subtypes: germinal center B cell-like (GCB-like) Type 2, expressing genes characteristic of normal germinal center B cells, with better prognosis; activated B cell-like (ABC-like) type, expressing genes characteristic of activated peripheral blood B cells and plasma cells, with poor prognosis; type III expression profile , other heterologous types without clear features, but the prognosis is the same as ABC.

After further determining the clinicopathological types, pathologists studied DLBCL by immunohistochemical methods, using a few markers that represented the differentiation lineage, and divided DLBCL into GCB-like and NON-GCB types, the latter including gene expression profiles.

Classified as ABC and III, these markers include: CD10 and bcl-6 as GCB markers, and MUM1 as NON-GCB marker.

Rosenwald et al reported that the 5-year overall survival rate of GCB type was 76%, and the 5-year overall survival rate of NON-GCB type was 34%. [1]

 


References
1. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW (Eds): World Health Organization Classification of Tumours of the Haematopoietic and Lymphoid Tissues. IARC Press:

Mark Hoppus was diagnosed with diffuse large B-cell lymphoma: What is this disease?

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