If you’ve been diagnosed with diffuse large B-cell lymphoma, you may have concerns about your disease prognosis. Your prognosis is an estimate of how your condition is likely to progress and what your outcome may look like. It describes your likelihood of responding to treatment, recovering, and surviving.
Your prognosis is partly determined by the DLBCL survival rate, a statistical tool used by oncology specialists to measure how long people with DLBCL tend to live after receiving their cancer diagnosis. Overall, experts estimate that about 65 percent of people survive this type of lymphoma for five years or more. However, this rate varies significantly depending on individual factors.
To estimate your DLBCL prognosis, your doctor will take into account prognostic factors — details that make you likely to have a better or worse outlook. Prognostic factors may include your personal risk factors such as family history of lymphoma, your overall health, and the characteristics of your DLBCL.
Based on studies between 2012 and 2018, 65 percent of people with DLBCL live for at least five years after diagnosis.
Younger adults tend to have a better outlook compared with older adults. For instance, according to the National Cancer Institute:
Health care providers use a measurement called performance status to describe the degree to which a person is affected by their lymphoma. Performance status estimates how well a person can complete daily activities such as taking care of themselves, doing things around the house, walking, and working.
If you have a better performance status score while living with DLBCL, you are likely to have a better prognosis. If you have a worse score — for example, you can’t work, need someone to help you around the house, or must stay in bed — you may have a worse prognosis.
Some studies have found that people with coexisting autoimmune disorders such as Sjӧgren’s syndrome, rheumatoid arthritis, and systemic lupus erythematosus tend to have a worse DLBCL prognosis.
Health experts don’t know for sure why autoimmune disorders may influence lymphoma outlook. It may be that people with these conditions tend to have worse performance status. Alternatively, having an autoimmune disorder may make it more difficult to tolerate aggressive chemotherapy regimens.
Some studies have found that people with coexisting autoimmune disorders, such as Sjӧgren’s syndrome, rheumatoid arthritis, and systemic lupus erythematosus, tend to have a worse DLBCL prognosis.
According to the American Cancer Society, a lymphoma’s stage describes how much cancer there is in the body. Health experts classify DLBCL into stages based on how many lymph nodes or organs contain cancer cells. Lymph nodes are the small structures located throughout your body that help filter out germs, extra fluid, and cancer cells from the surrounding tissues. The more cancer-containing lymph nodes you have, the later your lymphoma stage. (Cancer stages are sometimes noted with Roman numerals as stages I through IV.)
If you have advanced-stage lymphoma, you are likely to have a worse prognosis. The five-year survival rates, which describe how many people live at least five years with a condition, are as follows:
DLBCL cells are generally located in the lymph nodes. However, they may spread to other tissues or organs in advanced lymphoma cases. This is known as extranodal involvement. Having two or more sites of extranodal involvement is associated with a worse prognosis.
Lactate dehydrogenase (LDH) is an enzyme found in many tissues throughout your body. When these tissues undergo damage due to an illness like cancer, levels of LDH in your blood rise. A simple blood test can help measure the amount of LDH in your body.
Higher levels of LDH are linked to a worse prognosis for people with DLBCL and many other subtypes of non-Hodgkin lymphoma.
Lymphoma develops when white blood cells undergo gene changes that cause them to turn cancerous and grow out of control. Multiple types of gene mutations can lead to DLBCL.
Oncologists sometimes analyze gene changes to estimate prognosis. For example, if you have changes that affect your MYC, BCL2, or BCL6 genes, you may have a worse outlook.
When measuring your individual outlook with DLBCL, your doctor may use different models to evaluate prognostic factors, predict outcomes, and determine your risk of a relapse (return of your lymphoma).
This information can help your doctor create the optimal cancer treatment plan. If you have a poor prognosis, your doctor may recommend more aggressive treatments that could be more effective at fighting your lymphoma. However, if your outlook is good, your doctor may suggest avoiding these treatments so that you don’t have to experience their more severe side effects.
Many DLBCL treatments have been developed since the studies on which prognosis is based were done. People diagnosed with DLBCL today may have an improved prognosis.
The International Prognostic Index (IPI) combines multiple prognostic factors into one assessment. This model takes into account your:
The more poor prognostic factors you have, the more likely you are to experience a poor outcome. You may have a worse outlook if you:
Although the IPI is one of the most commonly used prognostic models for people with DLBCL, researchers have developed additional models that can predict outcomes with even greater accuracy. Your doctor may use these or other models when determining your prognosis.
One alternative model, the revised International Prognostic Index (R-IPI), uses the same prognostic factors as the IPI but calculates outlook in a slightly different way. The R-IPI is very useful in determining prognosis for people with DLBCL who undergo chemotherapy in addition to receiving rituximab (Rituxan), a targeted therapy drug.
The American Cancer Society reports that the overall five-year survival rate for DLBCL is 65 percent.
This overall survival rate is calculated based on information from people across the United States who were diagnosed with this blood cancer between 2012 and 2018. However, cancer therapies are constantly improving, and many new treatment options have been developed since then. Therefore, people diagnosed with DLBCL today might have an improved prognosis.
It’s important to keep in mind that survival rates don’t automatically reflect your outlook. Many individual factors also have an impact on prognosis. Talk to your health care team to get a better sense of your individual outlook and how this might be affected by different treatment options.
MyLymphomaTeam is the social network for people with lymphoma and their loved ones. On MyLymphomaTeam, more than 17,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.
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