Diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma is the most common, aggressive non-Hodgkin's lymphoma.

This disease (sub-type) starts in the lymphatic system. It often shows up as one or more enlarged lymph nodes and sometimes bone marrow or blood can show signs of the disease.

Some common symptoms patients develop that lead to a specialist include:

  • fevers
  • sweats
  • weight loss

Your first tests for diagnosis

Your specialist will need to perform a biopsy to confirm if you have Diffuse large B-cell lymphoma. There are different types of biopsies and your specialist will discuss the best option for you. Biopsy options include:

  • a guided needle to aspirate (remove) some lymph fluid for testing
  • a larger biopsy where a small piece of tissue is removed for testing
  • the removal of a lymph node

Using the biopsy, we will determine how far the disease has spread and how quickly it is growing. This is known as staging. Tests for staging usually include:

  • imaging
  • PET or CT scans
  • blood tests that help inform your specialist about the rest of your body

Some patients will also need a bone marrow biopsy to see if it has been affected. A bone marrow biopsy can also help guide the right treatment choice for you.


A biopsy is vital to diagnose your condition. To fully understand your condition, we test your sample using special stains (dyes). These stains help identify the exact disease and how quickly it is growing.

Our testing will also show if your disease is a sub-type of diffuse large B-cell lymphoma. Some sub-type diffuse large B-cell lymphomas include:

  • germinal centre diffuse large B-cell lymphoma
  • activated B diffuse large cell lymphoma
  • myc- rearranged B-cell lymphoma

Your biopsy results will guide what treatment is best for you.

Focusing on you (treatment)

Diffuse large B-cell lymphoma treatment depends on disease staging. Treatment will involve chemotherapy and possibly the use of an antibody treatment such as rituximab.

The most common type of chemotherapy used is called R- CHOP. R-CHOP is delivered to patients as part of our same day services. As an outpatient, you will receive about six cycles of this treatment. Each treatment cycle runs for a half day, once every three weeks.

To enhance your treatment we may also use radiotherapy. This can help control the disease and may reduce the number of chemotherapy cycles.

Sometimes, we will offer a different type of chemotherapy. The right treatment for you will depend on your biopsy results and your gene make-up. This will also help guide your participation in one of our clinical trials.

Enhancing your care (after treatment)

After effective treatment, patients will continue to see their specialist every three months. These visits are used to take and test bloods to monitor your health.

Some rare cases will need repeat PET or CT scans for a year or two. Your specialist will discuss the best follow-up plan for you.

Living with cancer

We know how hard cancer and treatment can be. Your lifestyle and that of your loved one's will be disrupted and changed. During this time, it is common to struggle with ongoing concerns about cancer and therapy.

There are many expert groups available to support you through this time, including:


At Peter Mac, we focus on all aspects of your health and wellbeing. Our ‘aggressive lymphoma’ specialist nurse will help support and guide you to the best information and managed care.

Our specialist nurse can refer you to our:


For more information about non-Hodgkin's lymphomas, their treatment and support for patients and families, download copies of the following resources: