Understanding your diagnosis

Diffuse large B-cell lymphoma (DLBCL) develops when a type of white blood cell, called a B cell, grows abnormally.

Your blood contains 2 major types of cells: red and white blood cells. B cells are white blood cells that protect your body from infection and disease.

In DLBCL, some B cells become cancerous when changes cause them to grow and multiply uncontrollably or survive for longer than usual.

Healthy B cells grow, divided, and die as they become old or damaged

Healthy B cells grow, divide, and die as they become old or damaged. 

In DLBCL, B cells either grow and multiply uncontrollably or survive for longer than usual.

Signs and symptoms

DLBCL can develop in the lymph nodes (structures that are part of the body’s immune system) or in other parts of the body, such as the gastrointestinal tract, testes, thyroid, skin, breast, bone, and brain.

DLBCL signs and symptoms can include:

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A lump*

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weight loss

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*swollen or enlarged lymph nodes in the neck, armpits, abdomen, or groin

Risk factors

DLBCL is an aggressive (fast-growing) blood cancer. Although it can occur at any age, its incidence increases with age. Most people are first diagnosed between the ages of 65 and 74.

DLBCL affects both men and women but is slightly more common in men. The exact cause of DLBCL is unknown.

Talk with your doctor to learn more about your specific diagnosis and risk factors.

DLBCL is the most common form of non-Hodgkin’s lymphoma (NHL), a diverse group of blood cancers that affect different types of white blood cells. In addition to DLBCL, high-grade B-cell lymphoma (HGBL) is a subset of NHL.

Receiving a diagnosis

Your doctor will talk with you about your symptoms and will evaluate them along with details from your comprehensive medical history. If your doctor suspects lymphoma after a physical exam, they may order a biopsy (removal of cells or tissue from your body) to confirm a diagnosis, determine the stage of disease and its subtype, and aid in treatment planning.

Your doctor may also order other diagnostic tests to help determine which type of lymphoma you have.

Treatment considerations in DLBCL

About 30-40% of people with newly diagnosed DLBCL are at risk of their cancer worsening or returning after treatment with traditional chemoimmunotherapy. When subsequent therapy for DLBCL is needed, the course of the disease has a worse outlook. This is why the first treatment choice is a vital decision.

When evaluating your treatment options with your healthcare team, it is important to understand how well the treatment works and the possible side effects of the treatment.

For a sample list of questions to help you prepare for your next doctor's visit and understand your diagnosis and treatment options, including if POLIVY may be right for you, download this discussion guide.

Your care team

Your care team is often more than just your primary care physician and your cancer doctor (oncologist).

While you were most likely diagnosed by a primary care physician or an oncologist, other healthcare providers may be involved at different stages in your journey. You may also hear your care team being called your “cancer care team” or a “multidisciplinary team". You may not see all these individuals, but they may be a part of your journey.

Who is on my care team?

The doctor who you see at regular checkups and who you call first when you feel ill. They refer you to specialists, if needed.

Also known as the hematologic oncologist (or heme-onc), a doctor who specializes in diagnosing and treating blood cancers and may lead your care team by working closely with all the other healthcare providers.

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Works directly with your oncologist and helps determine the results of your diagnostic tests. They play an important role in figuring out the type and severity of the cancer.

Healthcare professionals with whom you might have the most interaction during your treatment. Nurses help you talk to your doctor so you can make informed decisions, and they may help you set up appointments or medical tests.

A professional who guides you through the healthcare system. They may assist you with financial, social, legal, or insurance-related aspects of your healthcare needs.

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A multidisciplinary group of healthcare professionals that provides supportive and palliative care during your treatment cycles.

Fills prescriptions, addresses questions about how to take medicine, and advises you about any necessary precautions.

Helps you find ways to eat and hydrate appropriately and maintain your health during and after your cancer treatment.

Assists with the emotional and social aspects of dealing with cancer and can connect you with community, support services, and other resources to help you cope with difficult transitions.

Coaches you on ways to talk about your feelings and cope with them in order to better handle stress and anxiety.

A licensed professional who provides personal care to people at home and can help with bathing, dressing, and other daily chores.

R-CHOP is the traditional chemoimmunotherapy regimen that has been historically used in the treatment of newly diagnosed DLBCL. R-CHOP is an acronym for the following medicines: a rituximab product (R); cyclophosphamide (C); doxorubicin, also known as Adriamycin (H); vincristine, also known as Oncovin (O); and prednisone (P).

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Download resources and explore recommended informational sites and support groups.

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Questions To Ask Your Doctor

The doctor discussion guide provides a set of questions to ask your care team to help make sense of the information related to your diagnosis and treatment.

Important Safety Information and Indication

What does POLIVY® treat?

POLIVY is a prescription medicine used with other medicines (a rituximab product, cyclophosphamide, doxorubicin, and prednisone) as a first treatment for adults who have moderate to high risk diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) or high-grade B-cell lymphoma (HGBL).

POLIVY is a prescription medicine used with other medicines, bendamustine and a rituximab product, to treat DLBCL in adults who have progressed after at least 2 prior therapies.

Possible serious side effects

Everyone reacts differently to POLIVY therapy, so it’s important to know what the side effects are. Some people who have been treated with POLIVY have experienced serious to fatal side effects. Your doctor may stop or adjust your treatment if any serious side effects occur. Be sure to contact your healthcare team if there are any signs of these side effects.

  • Nerve problems in your arms and legs: This may happen as early as after your first dose and may worsen with every dose. Your doctor will monitor for signs and symptoms, such as changes in your sense of touch, numbness or tingling in your hands or feet, nerve pain, burning sensation, any muscle weakness, or changes to your walking pattern
  • Infusion-related reactions: You may experience fever, chills, rash, breathing problems, low blood pressure, or hives within 24 hours of your infusion
  • Low blood cell counts: Treatment with POLIVY can cause severe low blood cell counts. Your doctor will monitor your blood counts throughout treatment with POLIVY
  • Infections: If you have a fever of 100.4°F (38°C) or higher, chills, cough, or pain during urination, contact your healthcare team. Your doctor may also give you medication before giving you POLIVY, which may prevent some infections, and will monitor your blood counts throughout treatment with POLIVY. Treatment with POLIVY can cause severe low blood cell counts
  • Rare and serious brain infections: Your doctor will monitor closely for signs and symptoms of these types of infections. Contact your doctor if you experience confusion, dizziness or loss of balance, trouble talking or walking, or vision changes
  • Tumor lysis syndrome: Caused by the fast breakdown of cancer cells. Signs include nausea, vomiting, diarrhea, and lack of energy
  • Potential harm to liver: Some signs include tiredness, weight loss, pain in the abdomen, dark urine, and yellowing of your skin or the white part of your eyes. You may be at higher risk if you already had liver problems or you are taking other medication

Side effects seen most often

The most common side effects of POLIVY when used as a first treatment in DLBCL with the medicines rituximab product, cyclophosphamide, doxorubicin, and prednisone include

  • Nerve problems in arms and legs
  • Nausea
  • Tiredness or lack of energy
  • Diarrhea
  • Constipation
  • Hair loss
  • ​​​Redness and sores of the lining of the mouth, lips, throat, and digestive tract

POLIVY may lower your red or white blood cell counts and increase uric acid levels.

The most common side effects of POLIVY when used in DLBCL after at least 2 prior therapies with other medicines, bendamustine and a rituximab product include

  • Low blood cell counts (platelets, red blood cells, white blood cells)
  • Nerve problems in arms and legs
  • Tiredness or lack of energy
  • Diarrhea
  • Nausea
  • Fever
  • Decreased appetite
  • Infections

POLIVY may not be for everyone. Talk to your doctor if you are

  • Pregnant or think you are pregnant: Data have shown that POLIVY may harm your unborn baby
  • Planning to become pregnant: Women should avoid getting pregnant while taking POLIVY. Women should use effective contraception during treatment and for 3 months after their last POLIVY treatment. Men taking POLIVY should use effective contraception during treatment and for 5 months after their last POLIVY treatment
  • Breastfeeding: Women should not breastfeed while taking POLIVY and for 2 months after the last dose

These may not be all the side effects. Talk to your healthcare provider for more information about the benefits and risks of POLIVY treatment.

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

Please see the full Prescribing Information for additional Important Safety Information.