From the Guidelines
Non-Hodgkin B cell lymphomas can cause various side effects as the disease progresses, including persistent swollen lymph nodes, unexplained weight loss, fever, night sweats, and fatigue, with more severe symptoms indicating a higher risk of morbidity and mortality 1.
Common Symptoms
- Persistent swollen lymph nodes in the neck, armpit, or groin
- Unexplained weight loss
- Fever
- Night sweats
- Fatigue
Organ-Specific Symptoms
- Abdominal pain or swelling if lymph nodes in the abdomen are affected
- Chest pain, coughing, or breathing difficulties when lymph nodes in the chest are involved
- Skin rashes or itching
- Neurological issues if the brain is affected
Disease Progression
As the disease advances, it can cause:
- Anemia
- Increased susceptibility to infections
- Easy bruising or bleeding due to low blood cell counts
- B symptoms (fever, night sweats, weight loss) indicate more aggressive disease
Immune System Dysfunction
The immune system dysfunction can lead to increased risk of infections, as lymphoma cells disrupt normal lymphocyte function and crowd out healthy cells in the bone marrow and lymphatic system, interfering with normal immune function and blood cell production 1.
Treatment-Related Side Effects
Treatment with monoclonal antibodies, such as rituximab, can cause side effects like infusion-related reactions, low-grade infections, and IgM flare, which may lead to clinical complications 1. Therefore, it is essential to closely monitor patients with non-Hodgkin B cell lymphomas for these side effects and adjust treatment accordingly to minimize morbidity and mortality and improve quality of life 1.
From the FDA Drug Label
ADVERSE REACTIONS Most common adverse reactions in clinical trials were: NHL (greater than or equal to 25%): infusion-related reactions, fever, lymphopenia, chills, infection, and asthenia (6.1). The side effects of non-Hodgkin B-cell (B cell) lymphomas when treated with rituximab include:
- Infusion-related reactions
- Fever
- Lymphopenia
- Chills
- Infection
- Asthenia 2
From the Research
Side Effects of Non-Hodgkin B-Cell Lymphomas
The side effects of non-Hodgkin B-cell lymphomas can be significant and varied. Some of the most common side effects include:
- Neutropenia (73% of patients) 3
- Thrombocytopenia (21% of patients) 3
- Febrile neutropenia (18% of patients) 3
- Anaemia (18% of patients) 3
- Hypotension (6% of patients) 3
Treatment-Related Side Effects
Treatment for non-Hodgkin B-cell lymphomas, such as R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), can also cause significant side effects, including:
- Additive toxicity without clear benefit from dose intensification of chemotherapy 4
- Increased toxicity from dose-dense regimens 5
- Potential for dose reduction, particularly in elderly patients or those with comorbidities 5
Molecular Subtypes and Targeted Therapies
Research has identified distinct molecular subtypes of non-Hodgkin B-cell lymphomas, which may be associated with specific side effects and treatment outcomes. For example:
- Gene expression profiling has identified distinct molecular subtypes of DLBCL, which may be characterized by distinct oncogenic mechanisms and addictions to aberrant intracellular signaling pathways 4
- Novel therapeutic agents that target these pathway addictions are emerging, and may have specific activity within molecular subtypes of DLBCL 4