Staging diffuse large B-cell lymphoma (DLBCL)
It’s important for doctors to find out the stage of the lymphoma, as it will help them recommend the best treatment for you.
What you need to know
- The aim of staging is to give doctors all the information they need to plan your treatment.
- Your stage is expressed as a number, stage 1 to 4, followed by at least one letter.
- All lymphomas are staged using the same system.
How doctors work out your stage
The stage of the lymphoma is based on:
- which parts of your body are affected
- the symptoms you have
- how large any swollen lymph nodes are.
Stage numbers 1 to 4
The numbered stages for lymphoma describe where the lymphoma is in your body:
Stage 1: Only one lymph node or group of lymph nodes is affected, in one place in your body.
Stage 2: More than one group of nodes is affected but all of them are on the same side of the diaphragm, either above or below it. (The diaphragm is the sheet of muscle that separates your chest from your stomach area.)
Stage 3: Lymph nodes on both sides of the diaphragm are affected.
Stage 4: The lymphoma has spread to other organs, such as the lungs, liver or bone marrow.
Sometimes you might see these numbers written as Roman numerals I, II, III and IV.
Letters added to your stage
Your doctor may also add letters to describe the lymphoma in more detail:
B means you have one or more B symptoms. B symptoms are fever, unexplained weight loss and night sweats.
A means you don’t have any B symptoms.
E means the lymphoma has extended from an affected lymph node into another organ close to it.
X means you have bulky disease – a lymph node that measures 10cm or more, or a swelling in your chest that is at least a third of its width.
S means there is lymphoma in your spleen, an organ that is part of your immune system.
So, you may be told, for example, the lymphoma is stage 2A, or stage 4BX.
Having a higher number or more than one letter does not mean that the treatment will work less well. It’s about making the right choice of treatment.
Talk to other people affected by blood cancer
Hear from and connect with people who understand.
Early stage and advanced stage
Your hospital team may tell you that you have early stage or advanced stage DLBCL. Early stage is stages 1 and 2, and advanced stage is stages 3 and 4.
You may feel even more worried about your diagnosis if you hear that the DLBCL is advanced. It’s important to know that the stage of the DLBCL does not necessarily affect your prognosis (what is likely to happen in the future). The point of staging is to choose the treatment that will work best.
Your doctor may also work out a risk score. The risk score says more about your prognosis. Read about risk scores and the prognosis for DLBCL.