NCCN Guidelines for Patients® | Diffuse Large B-cell Lymphoma

17 NCCN Guidelines for Patients ® : Diffuse Large B-cell Lymphoma, 2017 levels may be a sign that treatment may be needed now or soon. Beta-2 microglobulin Beta-2 microglobulin is a small protein made by many types of cells, including lymphoma cells. It is measured with a blood chemistry test. If related to lymphoma, high levels may be a sign that treatment may be needed now or soon. This test may be useful to gauge the extent of the cancer. This test is not often used for DLBCL but may be useful at times. Hepatitis testing Hepatitis B can be an important factor in the treatment of DLBCL. Hepatitis B can become active again due to the cancer or some of its treatments. Thus, tell your treatment team if you’ve ever been infected with hepatitis. If you’re unsure, ask your treatment team if you should get tested. Testing may be needed if you will be treated with a drug called rituximab. Uric acid Some people with DLBCL are at risk for TLS ( t umor l ysis s yndrome). This syndrome can be life threatening. It occurs when the waste released by dead cells is not quickly cleared out of your body. This results in kidney damage and severe blood electrolyte disturbances. TLS can occur among people with DLBCL who are undergoing strong cancer treatments. The cancer treatment kills many cancer cells. In turn, too much tumor cell waste is released within in a short period of time. Your doctors may want to know your uric acid level before starting treatment. You may be given certain medications that can help prevent TLS. Also, drinking plenty of water throughout chemotherapy can help. Ask your treatment team for more information. HIV testing If you have HIV, treating it is an important part of treating DLBCL. HIV treatment will improve how well cancer treatment works. In addition, your DLBCL may be managed differently. Thus, tell your treatment team if you have HIV and about your treatment. If you are unsure, ask your treatment team if you should get tested. 2 Treatment planning Blood tests My diagnosis was sudden, unexpected and life shattering. I am a non-smoker and runner, and had just completed a ½ marathon before diagnosis. My only symptom was a persistent cough. My tumor was 10 cm by 14 cm and causing fluid to back up in my heart and lungs. – Angie Survivor, Age 52 at diagnosis “

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