Understanding Diffuse Large B-Cell Lymphoma Stage I
Diffuse large B-cell lymphoma, often shortened to DLBCL, is a type of blood cancer that begins in white blood cells called B cells, which normally help your body fight infections. When a person has DLBCL, these B cells undergo changes that make them grow abnormally and multiply much faster than healthy cells. In stage I, the disease is localized, meaning it affects only one lymph node or a group of lymph nodes in one part of the body.[6]
This is a fast-growing lymphoma, which is why doctors call it aggressive or high-grade. Despite this description, the word “aggressive” doesn’t necessarily mean the outlook is poor. In fact, because the cancer responds actively to treatment, many people with stage I DLBCL can be cured, especially when the disease is detected and treated quickly.[1][4]
The name “diffuse large B-cell lymphoma” comes from the way the disease looks under a microscope. The cancer cells are larger than normal, healthy B cells, and they spread out in a diffuse pattern rather than clustering together. This spreading pattern is what gives the disease its name.[3][4]
How Common Is This Disease
Diffuse large B-cell lymphoma is the most common type of non-Hodgkin lymphoma worldwide. It accounts for about 30 to 40 percent of all cases of non-Hodgkin lymphoma diagnosed in adults. In the United Kingdom alone, approximately 5,000 people receive a DLBCL diagnosis each year.[3][4][7]
When looking at the population as a whole, DLBCL is still relatively uncommon compared to other cancers. In 2020, about 6 people in 100,000 were diagnosed with DLBCL in the United States. To put this in perspective, roughly 500 people in 100,000 received a diagnosis of any type of cancer affecting their bodies during the same period.[1][5]
The disease is more common in men than in women. It can occur at any age, including in children, but it is most often diagnosed in older adults. The median age at diagnosis is around 60 to 70 years, meaning half of the people diagnosed are older than this age and half are younger.[3][11][14]
What Causes Diffuse Large B-Cell Lymphoma Stage I
Diffuse large B-cell lymphoma happens when B cells mutate, or change, in ways that are not normal. These changes occur during a person’s lifetime, not at birth. In other words, they are acquired genetic mutations rather than inherited ones.[1][12]
Scientists have identified more than 70 different genetic mutations linked to DLBCL. These mutations cause B cells to grow larger than they should and to multiply out of control. The abnormal cells lose their ability to fight infections and instead build up in the lymph nodes or other organs.[3][14]
While researchers understand that genetic changes drive the disease, they are not always sure what triggers these mutations in the first place. In some people, DLBCL develops from a previously existing low-grade B-cell lymphoma that transforms into a more aggressive form. In other cases, there is no clear preceding condition.[14]
Risk Factors for Developing DLBCL
Certain factors increase the likelihood that a person will develop diffuse large B-cell lymphoma. Having a family history of lymphoma can raise your risk, suggesting that genetic factors may play a role in some cases.[14]
Infections with certain viruses are also linked to an increased risk. People with HIV, the virus that causes AIDS, are at greater risk of developing DLBCL. Similarly, infection with the Epstein-Barr virus, which causes infectious mononucleosis (often called “mono”), is associated with some subtypes of the disease.[1][14]
Having an autoimmune disorder, where the body’s immune system attacks its own tissues, can also increase the risk. Conditions such as rheumatoid arthritis, Sjӧgren’s syndrome, and systemic lupus erythematosus have been linked to a higher likelihood of developing DLBCL.[19]
A personal history of chemotherapy or radiation therapy for a previous cancer is another risk factor. Additionally, people who have had a low-grade B-cell lymphoma or chronic lymphocytic leukemia in the past may develop DLBCL as their disease changes over time.[14]
Individuals with weakened immune systems due to organ transplants or other conditions that suppress immune function are also at increased risk. This is because the immune system normally helps control abnormal cell growth.[14]
Recognizing the Symptoms
The most common symptom people notice with diffuse large B-cell lymphoma is a painless swelling in one or more areas where lymph nodes are located. These swollen areas often appear as lumps in the neck, armpits, or groin. The lump typically doesn’t hurt, but in some cases it can be uncomfortable or painful. Because the swelling doesn’t go away and may actually grow larger over time, it often prompts people to see a doctor.[1][12]
Stage I DLBCL means the swelling is limited to one lymph node or group of nodes in a single area of the body. However, DLBCL can also develop outside the lymph nodes, in organs such as the stomach, intestines, thyroid, skin, or bone. When this happens, symptoms depend on which organ is affected.[1][3]
About 30 percent of people with DLBCL experience what doctors call B symptoms. These include a fever above 103 degrees Fahrenheit (39.5 degrees Celsius) that lasts longer than two days or comes and goes without an obvious cause. Another B symptom is unexplained weight loss, specifically losing more than 10 percent of your body weight over six months without trying. The third B symptom is heavy night sweats, intense enough to drench your sheets.[1][12]
Some people also experience severe itching without a rash, although this is less common. Other symptoms may include fatigue, loss of appetite, and shortness of breath if the lymphoma is pressing on the chest or lungs.[3][14]
Because DLBCL is fast-growing, symptoms can start or get worse within just a few weeks. This rapid progression is a key reason why it’s important to see a healthcare provider if you notice any of these changes in your body.[3]
Prevention Strategies
Unfortunately, there is no guaranteed way to prevent diffuse large B-cell lymphoma, as the exact causes of the disease are not fully understood. However, there are steps that may help reduce your risk or catch the disease early.
Maintaining a healthy immune system is important. If you have HIV, hepatitis B, or hepatitis C, working with your doctor to manage these infections may help lower your risk of developing lymphoma. Taking prescribed medications and following treatment plans for these conditions is essential.
If you have an autoimmune disorder, staying on top of your treatment and working closely with your healthcare team can help manage your overall health. While this may not directly prevent lymphoma, it can improve your body’s ability to function properly.
Paying attention to changes in your body is also key. If you notice a lump that doesn’t go away, unexplained fevers, drenching night sweats, or unexpected weight loss, don’t ignore these symptoms. Seeing a doctor promptly can lead to earlier diagnosis and treatment, which improves outcomes.
There are no vaccines or supplements specifically proven to prevent DLBCL. However, leading a healthy lifestyle with regular exercise, a balanced diet, and avoiding tobacco may support your overall health and immune function.
How the Disease Affects the Body
To understand how diffuse large B-cell lymphoma affects the body, it helps to know what B cells normally do. B cells are a type of white blood cell that circulates in the blood and moves through the lymphatic system, a network of vessels and organs that helps fight infection. When your body encounters a virus or bacteria, B cells produce antibodies that target and destroy these invaders.[1][3]
In DLBCL, B cells undergo genetic changes that make them grow larger than normal and multiply uncontrollably. These abnormal cells no longer function properly. Instead of protecting the body from infection, they crowd out healthy cells and take up space in the lymph nodes or other tissues.[1][12]
As the cancerous B cells accumulate, they cause lymph nodes to swell. In stage I, this swelling is limited to one area of the body. The lymph nodes may feel firm and enlarged under the skin. Because the abnormal cells are not doing their job of fighting infections, people with DLBCL may become more vulnerable to illnesses.[3]
The cancer cells can also spread out into the surrounding tissue, which is why the disease is called “diffuse.” This spreading pattern means the cells are not confined to one small cluster but are dispersed throughout the affected area. If left untreated, DLBCL can progress beyond stage I and spread to other lymph nodes or organs in the body.[3][4]
Because DLBCL is a fast-growing cancer, the abnormal cells divide and multiply rapidly. This is different from slow-growing lymphomas, where the disease may take years to cause noticeable symptoms. In DLBCL, symptoms can develop and worsen within weeks, reflecting the aggressive nature of the disease.[3][4]
