What Is B-Cell Lymphoma and How Is It Managed?

Written by Deanna Altomara, Marijke Vroomen Durning, RN
Medically Reviewed by Brunilda Nazario, MD on November 13, 2025

B-cell lymphoma is a cancer that forms in white blood cells called lymphocytes. These cells are made by your bone marrow and play an important role in your body's ability to fight infections. These cells mature in your lymphatic system, which includes a few organs found throughout your entire body, so B-cell lymphoma can start in different places. These cells normally mature into antibody-producing cells that fight bacteria, viruses, and toxins. The symptoms you have depend on where your cancer forms. But you can have B-cell lymphoma for many years before you notice any symptoms.

Getting a diagnosis of lymphoma is scary, as it is with any cancer type. But empowering yourself with information can help. Your doctors and other members of your care team can help you at every step of the way. It's also a good idea to reach out to family and friends to get the emotional backing you need while you learn how to manage life with your condition.

There are two main categories of lymphoma. They're called Hodgkin's lymphoma and non-Hodgkin's lymphoma. Most B-cell lymphomas are non-Hodgkin's lymphoma.

B-cell lymphomas come in many different types. They can act differently, too. Some grow quickly and others grow more slowly. Your doctor will help you understand which type you have and how best to treat it.

Other types of B-cell lymphoma 

It's possible to have other types of B-cell lymphoma. Some other types include:

  • High-grade B-cell lymphoma
  • Cutaneous B-cell lymphoma
  • Hairy cell leukemia

If you or a loved one has B-cell lymphoma and you aren't sure which type it is or what it means for your treatment or outlook, ask your doctor or another member of your care team to help you understand.

These cancers begin when abnormal lymphocytes grow out of control. Doctors don't know exactly what makes that happen. There's no way to say why some people get B-cell lymphoma and others don't. But there are certain risk factors that make B-cell lymphoma more likely. 

The role of lymphocytes

You have two main types of lymphocytes, called B cells and T cells. The lymphocytes involved in this type of lymphoma are B cells. You need these cells to make antibodies, which are proteins that help your body recognize and fight bacteria and viruses.

Lymphocytes travel around your body through a network called the lymphatic system. Lymph nodes – small glands in your neck, armpits, and groin – are part of this system. You've probably felt swollen lymph nodes in your neck when you got sick. Lymphoma grows in your lymph nodes or any other area of the body that has lymph tissue, including your spleen, bone marrow, thymus, adenoids, tonsils, and stomach.

Usually, your body makes new lymphocytes only when you need them to replace old cells that have died. When you have B-cell lymphoma, lymphocytes grow when you don't need them. Without treatment, they keep multiplying.

B-cell lymphoma risk factors

You're more likely to get B-cell lymphoma if your immune system is weaker than it should be. 

 

Even if you don't have any of these risk factors, you can still develop B-cell lymphoma for reasons that aren't clear. Similarly, just because you have these risk factors doesn't mean that you'll get B-cell lymphoma.

B-cell lymphoma doesn't always cause symptoms. If you have a slow-growing type, it might take months or even years before symptoms start. As your abnormal B cells multiply, they can cause parts of your body that have lymph tissue to get bigger. Sometimes, you can feel these lymph nodes once they've grown larger.

 B-cell lymphoma can cause symptoms including:

  • Night sweats
  • Fever
  • Unexplained weight loss
  • Fatigue
  • Appetite loss
  • Trouble breathing
  • Pain or swelling in your belly
  • Severe itching
  • Swollen, painless lumps in your lymph nodes (in your armpits, neck, or groin)
  • Rash or bumps on your skin
  • Enlarged liver or spleen

If you or a loved one has these symptoms and you don't know why, see your doctor. Many different conditions can cause these symptoms.

First, your doctor will ask you about your symptoms and medical history. They may ask you about your family history, too. You'll get a physical exam where the doctor checks your lymph nodes, liver, and spleen. They may recommend you see a hematologist-oncologist, a doctor who specializes in blood cancers. Your doctor may order tests to check for B-cell lymphoma. 

Blood tests

Blood tests can tell your doctor a lot about your overall health. You might start with:

Complete blood count (CBC) with differential. This test measures the levels of different types of your blood cells, including red blood cells, white blood cells, and platelets. Having this test done "with differential" will break down the different types of white blood cells, including your B cells. This can help doctors see if the amounts of various cell types in your blood look different than they should.

Comprehensive metabolic panel (CMP). This test checks on things in your blood that help to understand your organ function and metabolism. It looks at your electrolyte levels, blood sugar, liver and kidney function markers, and protein levels.

Lactate dehydrogenase (LDH) levels. With this test, your doctor can measure an enzyme – LDH – that's in your body. High LDH levels may be a sign of lymphoma.

These tests can give your doctor information about your B cells and other important parts of your blood. 

Imaging

Imaging tests give you and your doctor a picture of what's going on inside your body. They can use them to look for anything abnormal or suspicious, including tumors in your lymph nodes, liver, and spleen. Some imaging tests include:

Chest X-ray. Chest X-rays can show if you have enlarged lymph nodes in your chest or any other reason that may explain if you have trouble breathing.

Computed tomography (CT) scan. This is a specialized, rotating multi-X-ray test, which provides more detailed images of the inside of your body. 

Magnetic resonance imaging (MRI). This type of scan uses a magnetic field instead of radiation to produce cross-sectional images to see inside your body.

Positron emission tomography (PET) scan. This type of scan uses radioactive substances that are used by cells. Doctors can see where these build up as they flow through your body.

Ultrasound. Ultrasound uses high-frequency sounds that bounce off solid organs in your body and back, forming an image on a screen.

Biopsy 

A biopsy is the only test that can show whether you have B-cell lymphoma or not. Your doctor will take a sample of a lymph node and look for abnormal lymphocytes or other cells. Some types of biopsy are:

Needle biopsy. There are two types of needle biopsies: fine needle aspiration (FNA) and core needle biopsy. For both, your doctor would numb the skin above the lymph node they're worried about. For an FNA, the doctor inserts a fine needle attached to a syringe. Once it is in place, some tissue is pulled out of your lymph node. For core needle biopsy, your doctor inserts a larger needle so they can remove a bigger sample of your lymph tissue.

Excisional or incisional biopsy. In this procedure, your doctor removes all or part of your lymph node. If your doctor makes a cut to remove the whole node, it's an excisional biopsy. If the cut is smaller and your doctor takes only a portion of your lymph node out, it's an incisional biopsy.

Bone marrow aspiration and biopsy. In this procedure, your doctor removes some cells from inside one of your bones, usually the hip. You'll get a local anesthetic where the aspiration and biopsy will be done. Then your doctor will insert a needle into the bone and remove some of your liquid bone marrow to send to the lab. This is the aspiration. After the aspiration, your doctor would insert a larger needle into your bone and remove some bone tissue.

When you find out you have cancer, it's natural to have questions. Questions can be great conversation starters. They can help you learn more about the disease and what to expect. By asking questions, your doctor can help you understand your disease better and what you can do to manage life with B-cell lymphoma in the best way possible. They also can connect you with other specialists or professionals who can help with your symptoms or other concerns related to your cancer diagnosis.

Here are some questions to get you started:

  • What kind of lymphoma do I have?
  • What is the stage of my cancer?
  • What is my outlook for survival?
  • What tests do I need?
  • What are my treatment options? What are the pros and cons of each?
  • How long does treatment last?
  • What should I expect from treatment?
  • When should I call a doctor or go to the emergency room?
  • How can I reach you during an emergency?
  • Do I need to see any other doctors?

The type of treatment you'll get for your B-cell lymphoma depends on your overall health, the type of B-cell lymphoma you have, and whether it has spread. It will also depend on whether you have symptoms. You might get one treatment or a combination. Your doctor will help you find the treatment strategy that is right for you. It's important to let your care team know about your preferences, concerns, and treatment goals.

For example, diffuse large B-cell lymphoma grows quickly, so you might need more aggressive treatment if your diagnosis is DLBCL than if you have another lymphoma type. For many people, B-cell lymphomas don't need treatment right away. You and your doctor can choose to "watch and wait," which is also called active surveillance. During this time, your doctor will watch you closely. You'll have regular tests to see if the lymphoma is growing or spreading. If everything stays quiet or about the same, you'll continue with this plan. If there are any changes, your doctor might then recommend a treatment plan to try to put your lymphoma into remission.

Your treatment options for B-cell lymphoma may include:

Chemotherapy. This medication kills fast-growing cancer cells but also kills some healthy cells, which causes side effects. Chemotherapy medications can be used separately or in combination. For example, if you have DLBCL, primary mediastinal B-cell lymphoma, or follicular lymphoma, you might get CHOP. This is a combination chemotherapy of cyclophosphamide, doxorubicin, vincristine, and prednisone. If you also get another drug called rituximab, this is called R-CHOP. 

Immunotherapy. Immunotherapy medications help your own immune system to target and kill cancer cells.

Targeted therapy. These drugs target specific changes or mutations in cancer cells. For example, monoclonal antibodies or biologics work by targeting specific proteins found on the surface of abnormal lymphocytes.

Radiation therapy. Radiation directed where you have cancer can kill cancer cells.

Proton therapy. This treatment is similar to radiation therapy but is considered more precise and uses a different type of energy.

Stem cell transplantation. Since lymphoma affects your bone marrow, sometimes treatment involves killing off all your bone marrow cells and replacing them, through your veins, with new stem cells. These cells go through your body and settle in the marrow.

CAR T-cell therapy. Your own T cells are collected then engineered to recognize the cancer before being infused back into your body in large numbers. CAR T-cell therapy is now standard for treating B-cell lymphoma that comes back or doesn't respond to other medicines.

Sometimes, cancer treatment can cause side effects. Everyone is different, so your side effects may be different from those of someone else with B-cell lymphoma receiving the same treatment. Talk to your doctor about each of your treatment options and any side effects you should watch for. Make sure you know when to get help right away and the best way to reach a member of your care team at any time of day.

Common side effects include:

  • Diarrhea
  • Nausea
  • Fatigue
  • Fever
  • Low levels of neutrophils (a type of white blood cell)

You don't have to deal with these side effects on your own. Let your doctor know about any new or concerning symptoms. Ask about your options for palliative care, a type of treatment designed to manage your symptoms and the side effects of treatment.

Your B-cell lymphoma may lead to other health complications over time. 

Other health complications related to treatment for your B-cell lymphoma may include:

  • Fertility problems, whether you're male or a female
  • Early menopause
  • Dry eyes
  • Tooth decay
  • Osteoporosis

Let your doctor know anytime you have a new health concern. Your care team can help you figure out if it may be related to your B-cell lymphoma or its treatment. They also can refer you to other specialists for help, if needed.

B-cell lymphoma and its treatment can have a big impact on your life. It's important to take time for yourself, rest, and do things you enjoy. Some things that can help include:

Enjoy a balanced diet. You may not be feeling too hungry, which is a common side effect of chemotherapy. But right now, your body needs the fuel more than ever. Talk with a nutritionist about finding a meal plan that fits your needs and tastes.

Rest up. Your body needs time to recharge so it can fight the cancer. Take time to give it the rest and care it deserves.

Talk with someone. Everyone is different, but it can help to share your feelings with someone who cares, whether that's a friend or a therapist. Their support can help you get through the tough times and celebrate the good ones.

Try new coping skills. Practices like yoga, meditation, a walk in nature, and mindfulness can help you deal with stress.

No one can predict how your B-cell lymphoma will change over time. Your doctor can help you understand your B-cell lymphoma type and what you most likely can expect over time. Sometimes, a slow-growing type of lymphoma can turn into a type that grows faster. If this happens, it often turns into diffuse large B-cell lymphoma. But it can also transform into Burkitt lymphoma, Hodgkin's lymphoma, or other fast-growing types of lymphoma. If your B-cell lymphoma changes, it may affect your cancer treatment and outlook.

B-cell lymphoma prognosis

Your prognosis or outlook with B-cell lymphoma will depend on many things, including the type of lymphoma you have, how advanced the disease is, how well you respond to treatment, and your overall health, such as if you have any other diseases. The average life expectancy five years after someone is diagnosed with diffuse large B-cell lymphoma is about 65% (about 65 people out of 100 will live for five years after the diagnosis). The average five-year life expectancy for follicular lymphoma is 90% (9 out of 10 people with this diagnosis will live for at least five years).

Doctors use the International Prognostic Index (IPI) to help determine your outlook when you have any type of lymphoma. The index looks at your:

Age. If you're younger than 60, the index gives you a better prognosis than if you're older than 60.

Stage of lymphoma. Stages I and II have better prognosis than stages III or IV.

Whether the lymphoma has spread to your organs. If the lymphoma is in the lymph nodes or only one area outside of the nodes, there is a better prognosis than if the lymphoma has reached more than one organ outside the nodes.

How well you can do your everyday activities. Being able to function the way you normally would gives you a better prognosis than if you are struggling with daily activities.

What your lactate dehydrogenase (LDH) level is. A normal LDH level provides a better prognosis than a high level, which means there is more lymphoma in your body.

Using these details, your prognostic factor is described based on good factors or poor ones:

  • Low risk if you have no poor factors, or only one
  • Low to intermediate if you have two poor factors
  • High to intermediate if you have three poor factors
  • High risk if you have four or five poor factors

Another tool called the Follicular Lymphoma International Prognostic Index (FLIPI) is used for follicular lymphoma (a slow-growing type of B-cell lymphoma) because the IPI is not that good for this type. Like IPI, this index looks at your age, stage, and LDH level. It also considers your:

Blood hemoglobin. If your blood hemoglobin is 12 grams per deciliter (g/dL) or higher, you have a better prognosis than if it is lower than that.

Number of affected lymph nodes. Four or fewer nodes is better than more than four.

Using these details, your prognostic factor falls into one of three categories:

  • Low risk if you have no or one poor factor
  • Intermediate if you have two poor factors
  • High risk if you have three or more poor factors

Other people can be a great source of comfort, advice, and support after a diagnosis of B-cell lymphoma. If possible, consider reaching out to close friends and family. They can help you navigate the ups and downs of your cancer journey.

Think about ways the people in your network can best support you. Everyone has different strengths and can help in different ways. Some people might love to cook you dinner after a long day of treatment. Others could give you a ride to doctor appointments, or simply talk with you on the phone when you're feeling down.

You may want to consider joining a support group. This is where you can meet other people who are in a similar situation as you, so they understand what you're going through and how it feels. Ask your doctor about cancer support groups in your area. You can also reach out to CancerCare, Blood Cancer United (which used to be the Leukemia & Lymphoma Society), and the Lymphoma Research Foundation for resources and support.

Information for caregivers

If you're caring for someone with B-cell lymphoma, you also will benefit from information and support. Take the time you need and ask for support so you understand what is happening and can get help too. Talk with your loved one with B-cell lymphoma about their wishes and needs to identify the best ways you can help. Let them know you are there for them. Many organizations, including the American Cancer Society, offer resources and advice for cancer caregivers.

B-cell lymphoma is currently treated with chemotherapy, radiation, immunotherapy, and targeted therapy. But current research is underway to develop new treatments, with most focus on immunotherapy and targeted medicines.

Immunotherapy fires up the immune system so that it can fight off the cancer. In one type of immunotherapy called CAR T-cell therapy, doctors remove immune cells from your blood, supercharge them in a laboratory, and put them back into your bloodstream. There are also medicines and antibodies that can strengthen your immune responses. On the other hand, targeted therapies focus on a specific interaction between medicines and cancer cells. 

If you're interested in a clinical trial testing new treatments, ask your care team if there are options you could consider. You also can search for clinical trials testing new B-cell lymphoma treatments at ClinicalTrials.gov.

Of the several types of B-cell lymphoma, the most common one is a fast-growing type called diffuse large B-cell lymphoma, or DLBCL. Other types of lymphoma grow more slowly, and people can live longer with treatment. If you have B-cell lymphoma, speak to your doctor about your treatment options, what your individual outlook or prognosis is, and what your treatment plan will be.

What are the first symptoms of B-cell lymphoma? 

Swollen lymph nodes, a fever, and unexplained weight loss are some of the symptoms you might notice. But it might take years before you notice any symptoms from certain B-cell lymphomas. Later on, symptoms may change or become more obvious.

How fast does B-cell lymphoma spread?

Some types are aggressive (fast-spreading) and some types are indolent (slow-spreading).

How aggressive is large B-cell lymphoma? 

Large B-cell lymphoma is a fast-growing type of cancer. 

Does B-cell lymphoma run in families?

Diffuse large B-cell lymphoma doesn't run in families.

Can you be cured of B-cell lymphoma? 

For many people, treatment can cure B-cell lymphoma.

Does B-cell lymphoma show up in bloodwork? 

Blood tests can give your doctor clues about the health of your B cells, but only a biopsy can help show if you have cancer.

Is B-cell lymphoma the same as leukemia?

No. Leukemia is usually widespread in your bone marrow and blood, whereas lymphoma is usually found as a mass in your lymph nodes or spleen.

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