What is lymphoma?

Lymphoma is a type of cancer that forms in white blood cells called lymphocytes. The cells start to divide and develop abnormally.

They build-up in the body, and their function starts to fail.

Lymphocytes form a vital part of the immune system. They help the body detect abnormal cells, cancers, and infections so that they can be cleared from the system.

In lymphoma, abnormal white cells collect in the lymph glands and can also spread to the liver, lungs, or bone marrow.

In advanced disease, lymphoma cells can overwhelm the body, affecting its ability to fight infections and function normally.

However, most lymphomas respond well to specialist treatment and expert care.

What is B-cell lymphoma?

There are over 60 types of lymphoma. Discovering the specific type is essential because differing cancers respond to different kinds of treatments. 

The body has two main types of lymphocyte. When the cancer affects the B-cells, the disease is called B-cell lymphoma.

B-cells are critical for the immune system; they produce antibodies that can help the body fight viruses and bacteria; they can also bind to toxins and foreign substances so that the body can attack them.

Lymphomas are classified into two main groups: Hodgkin lymphomas and non-Hodgkin lymphomas. Haematologists diagnose Hodgkin’s disease, when they identify an abnormal cell, called a Reed-Sternberg cell, under the microscope. 

The vast majority of Hodgkin's lymphomas develop from the B-cells. Most non-Hodgkin's lymphomas also originate from the B-cells.

The most common non-Hodgkin’s lymphomas include:

Diffuse large B-cell lymphoma

This is the most common high-grade, or fast-growing, B-cell lymphoma

Follicular lymphoma

This is a low-grade lymphoma that develops slowly

Burkitt lymphoma

The most common type of non-Hodgkin's lymphoma seen in children. It is a high-grade cancer

Chronic lymphocytic leukaemia or cll

Cll is usually a slow-growing cancer. Many people live with it for a long time. The haematologists often treat it as a chronic condition that needs intermittent therapy to keep it under control.

Less common types of cancers include:

• Mantle cell lymphoma: this is usually a faster-growing, high-grade lymphoma but can also behave more like low-grade cancer
• Primary central nervous system lymphoma: this is a high-grade lymphoma that affects the brain, spinal cord, and eyes
• Hairy cell leukaemia: this low-grade lymphoma is very slow-growing and responds well to treatment

The classification of lymphoma is complicated and can be confusing. 

Our consultant haematologists have extensive expertise and experience in the diagnosis of lymphoma, they will explain your lymphoma type and customise a treatment programme to treat the cancer.

What are the causes and symptoms of B-cell lymphoma?

In B-cell lymphoma, abnormal lymphocytes build-up in the lymph glands. This causes swelling and lumps in parts of the body where there is lymph tissue.

Most people present with a swollen gland that hasn’t gone away.

Enlarged glands can also press on other structures, causing pain and other symptoms. Look out for:

• Lumps or swellings in the neck, armpit or groin
• Bone pain
• Breathlessness or coughing
• Chest pain
• Abdominal pain or a feeling of fullness
• Skin rashes and itching
• Brain and nerve symptoms such as dizziness, fits or limb weakness

As lymphoma develops, it can affect your immunity and spread to other parts of the body, causing what are typically called general symptoms.

Some of these are known as ‘B symptoms’ and will be carefully considered when your specialist assesses the stage of your disease and plans your treatment.

These general symptoms include:

• Fever
• Night sweats
• Unexplained weight loss
• Fatigue
• Itching
• Frequent infections

Many lymphoma symptoms can develop as a result of viruses and other more common conditions.

Having fatigue, a lump, or another symptom doesn’t necessarily mean you have lymphoma.

However, if you’re worried about lymphoma, see your GP or contact The London Clinic for assessment and tests.

How is B-cell lymphoma diagnosed?

The London Clinic provides accurate diagnosis, staging, and typing of lymphoma to ensure you get the best possible treatment for your particular cancer.

Many people are referred by their GP because of worrying symptoms or abnormal findings on blood tests or scans.

Alternatively, you may have already been diagnosed with lymphoma, and choose to attend The London Clinic to benefit from the state-of-the-art treatments and supportive care. 

The haematologist will take a careful look at your medical history, perform an examination to see if your lymph nodes are enlarged and check for a swollen liver or spleen.

They will then arrange investigations to find out more about your condition, which, depending on your symptoms and the findings of your initial examination, could include:

• Blood tests to check your blood counts, look for anaemia, and check liver and kidney function
• X-ray
• MRI scan
• CT scan
• Bone marrow biopsy: the specialist will remove a sample of bone marrow via a fine needle for detailed examination under the microscope
• Lymph node biopsy: under local anaesthetic, the surgeon removes a lymph node so that it can be tested for lymphoma cells

B-cell lymphoma staging

If your test results confirm the diagnosis of B-cell lymphoma, the consultant will then assess the stage of the disease, so that a treatment plan can be customised to your individual needs. 

Non-Hodgkin lymphoma is staged as:

• Stage I: the cancer is found in only one lymph node region or in a group of nodes nearby
• Stage II: cancer has invaded an organ, is present in two lymph node regions, and is limited to a section which is either below or above the diaphragm
• Stage III: cancer has moved to lymph nodes both below and above the diaphragm
• Stage IV: the most advanced stage of lymphoma, in which cancerous cells are found in different organs and tissues, such as the lungs and liver

Following testing, the letters A or B will be added to the condition. B shows that the individual is suffering from significant fever, weight loss, or night sweats.

A indicates that the person is not experiencing general symptoms.

What treatments are available for B-cell lymphoma?

The best treatment for your cancer will depend on the stage, location, and type of your lymphoma.

A diagnosis of cancer can be devastating, but many lymphomas are highly responsive to treatment. Your consultant will discuss the options with you and develop a personalised programme of treatment.

This could include:

Excision surgery

The surgeon removes discrete glands containing lymphoma cells; they may also remove nearby nodes to check for spread.

Chemotherapy

Different combinations of chemotherapy can be given by mouth or intravenous injection. These can kill lymphoma cells and prevent them from dividing and spreading. 

The London Clinic has 22 outpatient pods so that patients can receive chemotherapy treatment in comfort and privacy.

Targeted cancer drugs

Innovative medications can harness the body's own healing powers to attack cancer cells.

The London Clinic offers a range of these revolutionary treatments, including the monoclonal antibody Rituximab for the treatment of some types of non-Hodgkin lymphoma and chronic lymphocytic leukaemia.

Radiotherapy

Targeted high-energy X-ray radiation is directed at the lymphoma to destroy cancer cells and prevent them from spreading and growing.

The Duchess of Devonshire Wing, The London Clinic’s dedicated cancer care centre, has a suite with the latest image-guided and intensity-modulated radiotherapy.

Car-t immunotherapy for B-cell lymphoma

The London Clinic offers this transformative cell therapy. It is a cutting-edge treatment for adults with diffuse large B-cell lymphoma.

Immune cells are collected from patients and genetically modified to destroy cancer cells. This revolutionary therapy can offer hope for people who have no other treatment options.