B-cells are a type of white blood cell, known as a lymphocyte, that functions within the adaptive immune system. Their primary role is to produce proteins called antibodies that identify and neutralize foreign invaders like bacteria and viruses. This process is part of the body’s humoral immunity. When B-cells become cancerous, they multiply uncontrollably, leading to B-cell cancer. These abnormal cells can then accumulate in various parts of the body and disrupt normal functions.
Types of B-Cell Cancers
B-cell cancers are a diverse group of malignancies, primarily categorized as lymphomas originating in the lymphatic system. The two main groups are Non-Hodgkin Lymphoma and Hodgkin Lymphoma, distinguished by the presence or absence of a specific cell type.
Over 85% of lymphomas are B-cell Non-Hodgkin Lymphomas (NHL). The most prevalent subtype is Diffuse Large B-cell Lymphoma (DLBCL), an aggressive cancer and the most common type of NHL. Another frequent subtype is Follicular Lymphoma, which is slow-growing and accounts for about one in five lymphomas in the United States.
Hodgkin Lymphoma is a less common form of lymphoma and is uniquely identified by the presence of Reed-Sternberg cells, which are large, abnormal lymphocytes. These cells are not found in Non-Hodgkin Lymphoma. The distinction is important for determining the course of treatment and prognosis.
Other B-cell cancers include Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL). In CLL, cancer cells are mainly in the blood and bone marrow, while in SLL, they are in the lymph nodes and spleen. Multiple Myeloma is another type that affects plasma cells, a mature B-cell that produces antibodies, causing malignant plasma cells to build up in the bone marrow.
Common Symptoms and Signs
The manifestations of B-cell cancer can be varied and depend on the specific type and location of the malignancy. One of the most frequently reported signs is the painless swelling of lymph nodes, commonly detected in the neck, armpits, or groin.
Individuals may also experience a cluster of systemic issues known as “B symptoms.” These include unexplained fevers, drenching night sweats, and unintentional weight loss of more than 10% of body weight over six months. The presence of B symptoms can indicate a more aggressive form of lymphoma.
General feelings of sickness and fatigue are also common. This persistent exhaustion is not relieved by rest and can interfere with daily activities. Other signs may include shortness of breath or a cough if the cancer affects lymph nodes in the chest. Because B-cells are part of the immune system, their malfunction can lead to an increased susceptibility to infections.
The Diagnostic Pathway
Diagnosing B-cell cancer begins with a detailed medical history and a physical examination, where a physician pays close attention to the lymph nodes, spleen, and liver for any swelling. Blood tests, such as a complete blood count (CBC), provide information about the numbers and appearance of different blood cells. Imaging studies like CT and PET scans are used to visualize the extent and location of the cancer.
The definitive method for diagnosis is a biopsy. This procedure involves removing a small tissue sample, often from an enlarged lymph node or bone marrow, for examination by a pathologist. The pathologist analyzes the tissue under a microscope to identify cancerous cells and determine the specific type of B-cell malignancy. This analysis confirms the diagnosis and guides treatment planning.
Overview of Treatment Strategies
Managing B-cell cancers involves several therapeutic approaches, often used in combination and tailored to the cancer type, stage, and the patient’s health. The primary goal is to destroy cancerous B-cells and induce remission. Common treatments include chemotherapy and radiation therapy.
Chemotherapy utilizes drugs designed to kill rapidly dividing cells, a characteristic of cancer. These drugs can be administered orally or intravenously and travel throughout the body. Radiation therapy, on the other hand, uses high-energy rays to target and destroy cancer cells in a specific, localized area.
Newer treatments offer more precise ways to combat B-cell cancers. Targeted therapy drugs identify and attack specific molecules on cancer cells, leaving healthy cells largely unharmed. Immunotherapy harnesses the body’s own immune system to fight cancer. Examples include monoclonal antibodies, which are lab-created proteins that mark cancer cells for destruction, and CAR T-cell therapy, where a patient’s T-cells are engineered to kill cancer cells.