Non-Hodgkin’s lymphoma

What Is Non-Hodgkin’s Lymphoma?

Non-Hodgkin’s lymphoma encompasses a broad group of blood cancers arising from lymphocytes, with diffuse large B cell lymphoma representing the single most common subtype, accounting for roughly thirty to forty percent of adult lymphoma diagnoses.¹

Both diffuse large B cell lymphoma and follicular lymphoma, another common subtype, arise from a specific structure within lymph nodes called the germinal center, where B cells normally undergo a process of maturation and antibody refinement as part of a healthy immune response.¹

Follicular lymphoma typically follows an indolent, slow moving course in most patients, though some cases behave more aggressively over time, occasionally transforming into the more aggressive diffuse large B cell lymphoma subtype.²

Diffuse large B cell lymphoma is the most frequent type of non-Hodgkin malignant lymphoma, comprising thirty to forty percent of adult lymphomas, and represents a heterogeneous disease characterized by different pathological, clinical, and molecular entities.
National Center for Biotechnology Information

Symptoms

Painless swelling of lymph nodes represents the most recognizable symptom of non-Hodgkin’s lymphoma, though the pace at which this develops differs considerably between aggressive and indolent subtypes.

Diffuse large B cell lymphoma often presents relatively quickly, with rapidly enlarging lymph nodes and systemic symptoms including fever and weight loss, reflecting its more aggressive nature.

Follicular lymphoma, by contrast, frequently develops so gradually that patients may have swollen lymph nodes for months or longer before seeking evaluation, consistent with its generally slower, more indolent disease course.²

Causes

Diffuse large B cell lymphoma arises from B cells within the germinal center undergoing malignant transformation, though the disease is now understood to actually represent several molecularly distinct diseases grouped under a single clinical name.³

Gene expression profiling has identified at least two major molecular subtypes of diffuse large B cell lymphoma, termed germinal center B cell like and activated B cell like, each associated with meaningfully different biology and response to standard treatment.³

Patients with the activated B cell like subtype tend to experience notably worse outcomes with standard immunochemotherapy compared to those with the germinal center B cell like subtype, illustrating why this molecular classification carries real clinical significance beyond simply providing academic interest.⁴

Risk Factors

Because diffuse large B cell lymphoma actually represents a heterogeneous collection of molecularly distinct diseases, individual risk and expected treatment response can vary considerably even among patients who initially appear to share the same diagnosis.¹

Cell of origin classification, determined through gene expression profiling combined with immunohistochemistry, has emerged as the strongest available predictor of survival among patients with diffuse large B cell lymphoma, surpassing many traditional clinical risk factors in prognostic power.⁴

For patients with follicular lymphoma, the possibility of transformation to more aggressive diffuse large B cell lymphoma represents an important, ongoing consideration throughout the disease course, meaningfully shaping longterm monitoring and management decisions.²

Complications

Transformation of follicular lymphoma into diffuse large B cell lymphoma represents a significant complication, since this shift toward more aggressive disease behavior often requires a meaningful change in treatment approach.²

Patients with the less favorable activated B cell like molecular subtype of diffuse large B cell lymphoma face a higher risk of treatment failure and relapse compared to patients with the more favorable germinal center subtype, even when treated with identical standard therapy.⁴

Relapsed or treatment resistant disease represents an ongoing challenge for a meaningful subset of patients, prompting continued development of new treatment approaches specifically targeting this more difficult to treat population.⁵

Treatment

Bispecific antibodies represent a significant recent treatment advance for relapsed or treatment resistant diffuse large B cell lymphoma, working by simultaneously engaging both lymphoma cells and the patient’s own immune cells to enhance tumor cell destruction.⁵

Two such medications, glofitamab and epcoritamab, have demonstrated meaningful response rates in heavily pretreated patients, with roughly forty percent of treated patients in pivotal trials achieving a complete response despite having already tried multiple prior treatments.⁵

These two bispecific antibodies differ somewhat in structure and administration, with epcoritamab given by injection under the skin and glofitamab given intravenously, offering clinicians and patients some flexibility in selecting an appropriate option based on individual circumstances.⁶

Prevention

Because non-Hodgkin’s lymphoma arises from complex genetic and molecular changes within lymphocytes, there is no established way to prevent the disease from developing in most patients.

For patients with follicular lymphoma, regular monitoring plays an important role in detecting early signs of transformation to more aggressive disease, allowing treatment adjustment before the transformed disease becomes more difficult to control.²

Molecular testing at diagnosis, including cell of origin classification, allows treatment planning to be informed by each patient’s specific disease biology rather than relying on a uniform, one size fits all treatment approach.⁴

Why Visual Communication Matters for Non-Hodgkin’s Lymphoma

Explaining how a single diagnosis like diffuse large B cell lymphoma actually represents several molecularly distinct diseases, each behaving differently, requires visuals that make this biological complexity understandable for patients navigating treatment decisions.

Pharmaceutical companies, hematology and oncology practices, and patient education organizations rely on clear illustration and animation to explain non-Hodgkin’s lymphoma and support informed treatment decisions.

• Illustrating germinal center biology and lymphoma cell of origin
• Animating the molecular subtypes underlying diffuse large B cell lymphoma
• Explaining the mechanism of action of bispecific antibody therapy
• Visualizing follicular lymphoma transformation to more aggressive disease
• Supporting patient education on molecular testing and personalized treatment
• Creating training materials for hematology and oncology clinicians

How Biotic Artlab Supports Non-Hodgkin’s Lymphoma Communication

We work with pharmaceutical companies, hematology and oncology practices, and patient advocacy organizations to create scientifically accurate visuals that make non-Hodgkin’s lymphoma and its treatment easier to understand.

• Custom 3D animations of germinal center biology and lymphomagenesis
• Detailed illustrations of molecular subtyping and cell of origin classification
• Mechanism of action animations for bispecific antibody therapies
• Patient facing materials on relapsed and treatment resistant disease options
• Clinical training content for hematology and oncology teams
• Conference presentations and marketing visuals for blood cancer audiences

Frequently Asked Questions

What is the most common type of non-Hodgkin’s lymphoma?

Diffuse large B cell lymphoma is the most common subtype, accounting for roughly thirty to forty percent of adult lymphoma diagnoses.¹

Is diffuse large B cell lymphoma one disease?

Not exactly. Gene expression profiling has identified distinct molecular subtypes with meaningfully different biology and treatment response.³

Can follicular lymphoma become more aggressive?

Yes, follicular lymphoma can transform into the more aggressive diffuse large B cell lymphoma, requiring a change in treatment approach.²

What is cell of origin classification?

It is a method using gene expression profiling to identify molecular subtypes of lymphoma, considered the strongest available predictor of patient survival.⁴

What are bispecific antibodies?

Bispecific antibodies are a newer treatment class that engage both lymphoma cells and immune cells simultaneously, showing meaningful response rates in relapsed disease.⁵

What is the difference between epcoritamab and glofitamab?

Both are CD20 directed bispecific antibodies, but they differ in structure and administration, with epcoritamab given subcutaneously and glofitamab given intravenously.⁶

Have a Project in Mind? Contact Us.

If you are developing patient education materials, clinical training content, or marketing visuals related to non-Hodgkin’s lymphoma or hematologic oncology, our team can help translate the science into visuals that are both accurate and easy to understand. Contact us at info@biotic-artlab.com or get in touch through our contact form to discuss your project.

References

1. National Center for Biotechnology Information. Diffuse Large B Cell Lymphoma, Epidemiology, Pathophysiology, Risk Stratification, Advancement in Diagnostic Approaches and Prospects.
2. National Center for Biotechnology Information. The Pathobiology of Follicular Lymphoma.
3. National Center for Biotechnology Information. Genetics and Pathogenesis of Diffuse Large B Cell Lymphoma.
4. National Center for Biotechnology Information. Cell of Origin Determined by Both Gene Expression Profiling and Immunohistochemistry Is the Strongest Predictor of Survival in Patients With Diffuse Large B Cell Lymphoma.
5. National Center for Biotechnology Information. Bispecific Antibodies and Antibody Drug Conjugates in Relapsed Refractory Aggressive Non-Hodgkin Lymphoma.
6. National Center for Biotechnology Information. Epcoritamab in Relapsed Refractory Large B Cell Lymphoma, 2 Year Follow Up From the Pivotal EPCORE NHL-1 Trial.

Disclaimer: This page provides general educational information and is not a substitute for diagnosis, treatment, emergency care, or individualized advice from a qualified healthcare professional.