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B-Cell Lymphoma Prognosis: Fear, Hope, and Understanding Survival Rates

Posted on June 30, 2022
Medically reviewed by
Mark Levin, M.D.
Article written by
Maureen McNulty

After being diagnosed with B-cell lymphoma, many people want to better understand their prognosis (outlook). Lymphoma prognosis describes how the disease is likely to progress and estimates a person’s chances of recovering. One way that researchers measure prognosis is through survival rates. To predict individual outlooks, doctors also take into account prognostic factors that play a role in disease outcomes.

Researchers are continually making breakthroughs and developing more effective lymphoma treatments. In particular, immunotherapy drugs like rituximab (Rituxan) have helped improve the prognosis for people diagnosed with non-Hodgkin lymphoma (NHL). It is not yet clear how some of these newer treatments affect long-term survival. Additional studies are needed to determine their impacts on the outlook for B-cell lymphoma.

What Are B-Cell Lymphomas?

B-cell lymphoma is a type of NHL that develops in white blood cells called B lymphocytes. About 85 percent of people with NHL have B-cell lymphoma, per the American Cancer Society. NHL can also develop in other types of lymphocytes, such as T cells, but these lymphomas are rare.

There are several types of B-cell lymphoma. Each type may grow at a different speed and lead to a different prognosis.

Survival Rates

Lymphoma prognosis is often measured using a five-year relative survival rate. This number is calculated using large groups of people from cancer databases or clinical trials. The survival rate describes how many people with a particular type of lymphoma are likely to live for five years or more, compared with the general population.

It is important to know that current survival rates are calculated using information from people who were diagnosed several years ago. Over the past few decades, the number of people who die from NHL has been steadily decreasing as doctors learn more about the disease and researchers develop better treatments. This means that people being diagnosed with NHL today may have better outcomes compared with current survival rates.

According to the American Cancer Society, among all cases of NHL, the five-year relative survival rate is 72 percent. This means that people with NHL are 72 percent as likely to live at least five years after diagnosis as people without NHL. However, survival rates change based on the type of lymphoma and the lymphoma stage (how far lymphoma cells have spread within the body).

Diffuse Large B-Cell Lymphoma

The American Cancer Society estimates that about 1 out of 3 people with NHL have diffuse large B-cell lymphoma (DLBCL) — a fast-growing lymphoma. However, treatments are usually effective and many people with this subtype can be cured. According to the National Cancer Institute, among all people with DLBCL, 63.9 percent live for five years or more after being diagnosed, compared with people without the disease. However, the five-year relative survival rate varies based on stage:

  • Stage 1 — 73.6 percent
  • Stage 2 — 73.6 percent
  • Stage 3 — 63.7 percent
  • Stage 4 — 53.2 percent

Follicular Lymphoma

Follicular lymphoma (FL) affects about 1 out of 5 people with NHL. FL is a slow-growing disease, and many people can live a long time with this condition. The five-year relative survival rate across all stages of FL is 89.7 percent. Survival rates are different across each stage of FL:

  • Stage 1 — 96.9 percent
  • Stage 2 — 90.6 percent
  • Stage 3 — 88.4 percent
  • Stage 4 — 83.2 percent

Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are considered to be different versions of the same disease. CLL and SLL affect the same type of white blood cell but occur in different places in the body. People with CLL usually have cancer in the blood and bone marrow (soft tissue found inside certain bones). SLL usually occurs in a part of the immune system called the lymphatic system.

Most cases of CLL and SLL are indolent lymphomas — they grow slowly. People diagnosed with CLL/SLL can live for many years or decades, but they can’t usually be cured. CLL/SLL has a five-year relative survival rate of 86.9 percent, per the National Cancer Institute.

Marginal Zone Lymphoma

An article in the Annals of Lymphoma stated that around 1 out of 10 people with NHL have marginal zone lymphoma (MZL). These lymphomas are often indolent. Doctors divide MZL into three subtypes depending on where the lymphoma occurs. Five-year relative survival rates vary based on the subtype of MZL:

  • Extranodal MZL, also called MALT lymphoma (occurs outside of the lymph nodes, in moist tissue that lines organs and body cavities) — 88.7 percent
  • Nodal MZL (develops in the lymph nodes) — 79.7 percent
  • Splenic MZL (occurs in the spleen) — 76.5 percent

Mantle Cell Lymphoma

Mantle cell lymphoma (MCL) affects about 5 percent of people with NHL. It can grow quickly, and treatments aren’t always effective. People with MCL live for an average of five to seven years.

Burkitt Lymphoma

Burkitt lymphoma is a fast-growing type of cancer. It accounts for 1 percent to 5 percent of adult lymphomas, as stated in StatPearls (a medical database that is frequently updated). Burkitt lymphoma is more common in children. The American Cancer Society states that about 4 out of 10 children with NHL have Burkitt lymphoma.

Overall, 61.2 percent of people with Burkitt lymphoma live for five years or more after being diagnosed, as stated in the journal Oncology Letters. However, adults with Burkitt lymphoma generally have a worse prognosis than children. Per StatPearls, at least 98 percent of children with early-stage Burkitt lymphoma will be successfully treated and survive the disease. Between 50 percent and 90 percent of children with more advanced disease survive long term.

Hairy Cell Leukemia

Hairy cell leukemia (HCL) is a rare type of lymphoma that usually affects men. HCL cells grow very slowly, and treatments often work well to treat the disease. Half of the people with HCL live for 27 years or more after being diagnosed.

Predicting Individual Outlook

Survival statistics don’t show what any one person’s prognosis will be. Doctors can better estimate individual outlook using prognostic factors. If you would like to learn more about your outlook, talk to your doctor, who can give you a better idea of what to expect based on your overall health and the characteristics of your lymphoma.

The International Prognostic Index

Doctors often use a system called the International Prognostic Index (IPI) to estimate NHL prognosis. The IPI considers several factors that are known to influence a person’s outlook. Factors that lead to a higher chance of having a poor prognosis include:

  • Advanced age (older than 60 years)
  • Stage 3 or stage 4 lymphoma
  • Lymphoma in tissues or organs outside of the lymph nodes
  • Worse performance status (a measure of how well a person can carry out normal daily activities)
  • High blood levels of an enzyme called lactate dehydrogenase (LDH)

The more of these negative prognostic factors a person has, the higher their risk of having a poor outcome will be. People who have high-risk lymphoma often need more aggressive treatments.

Other Systems to Measure Prognosis

Other systems besides the IPI also help doctors measure outlook for specific types of NHL. Researchers developed the National Comprehensive Cancer Network IPI (NCCN-IPI) to estimate DLBCL prognosis. The NCCN-IPI considers the same factors as the original IPI but calculates risk levels differently. Likewise, the follicular lymphoma IPI (FLIPI) measures FL prognosis. This system considers slightly different factors: age, stage, levels of LDH, levels of hemoglobin, and the number of lymph node groups containing cancer cells.

Your doctor may use these systems or others to calculate your risk level, estimate your outlook, and recommend treatment options. If you would like to learn more about your prognosis, ask your doctor to explain how your risk factors affect your outlook and treatment plan.

Talk With Others Who Understand

MyLymphomaTeam is the social network for people with lymphoma and their loved ones. On MyLymphomaTeam, more than 11,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

Are you living with B-cell lymphoma? Share your experiences in the comments below, or start a conversation by posting on MyLymphomaTeam.

All updates must be accompanied by text or a picture.
Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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