B symptoms
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Overview
B symptoms refer to systemic symptoms of fever, night sweats, and weight loss which can be associated with both Hodgkin's lymphoma and non-Hodgkin's lymphoma. The presence or absence of B symptoms has prognostic significance and is reflected in the staging of these lymphomas.
Description and nomenclature
B symptoms are so called because lymphoma staging includes both a number (I-IV) and a letter (A or B). "A" indicates the absence of systemic symptoms, while "B" indicates their presence.
B symptoms include:
- Fever greater than 38°C. Pel-Ebstein fever, the classic intermittent fever associated with Hodgkin disease, occurs at variable intervals of days to weeks and lasts for 1-2 weeks before resolving. However, fever associated with lymphoma can follow virtually any pattern.
- Drenching sweats, especially at night.
- Unintentional weight loss of >10% of normal body weight over a period of 6 months or less.
Prognostic importance
The presence of B symptoms is a marker for more advanced disease with systemic, rather than merely local, involvement. B symptoms are a clear negative prognostic factor in Hodgkin lymphoma.[1] The relevance of B symptoms in non-Hodgkin lymphoma is less clear, although here also B symptoms tend to correlate with disease that is either more widespread or of a higher histologic grade.[2]
Relative importance of specific B symptoms
It has been suggested that, in Hodgkin lymphoma, fever and weight loss are much more prognostically significant than night sweats. In one series of patients with early-stage Hodgkin disease, the presence or absence of night sweats had no impact on cure rates and outcome. However, fever and weight loss had a pronounced negative impact on cure and survival rates, regardless of treatment modality.[3]
"B symptoms" in other diseases
Similar systemic symptoms can be found in non-cancerous states such as tuberculosis and various inflammatory or rheumatologic conditions. In these settings, the term "B symptoms" is sometimes colloquially applied to refer to such systemic or constitutional symptoms. However, in a pure sense, the term "B symptoms" is restricted to lymphoma staging.
References
- ↑ Reevaluation of prognostic significance of symptoms in Hodgkin's disease. Gobbi PG; Cavalli C; Gendarini A; Crema A; Ricevuti G; Federico M; Di Prisco U; Ascari E. Cancer 1985 Dec 15;56(12):2874-80.
- ↑ Malignant lymphoma: the histology and staging of 473 patients at the National Cancer Institute. Anderson T; Chabner BA; Young RC; Berard CW; Garvin AJ; Simon RM; DeVita VT Jr. Cancer 1982 Dec 15;50(12):2699-707.
- ↑ Stage I to IIB Hodgkin's disease: the combined experience at Stanford University and the Joint Center for Radiation Therapy. Crnkovich MJ; Leopold K; Hoppe RT; Mauch PM. J Clin Oncol 1987 Jul;5(7):1041-9.
External Resources
- UpToDate, accessed August 2006
WikiDoc Research Resources for B symptoms | |
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| Articles on B symptoms | Most recent articles on B symptoms • Most cited articles on B symptoms • Review articles on B symptoms • Articles on B symptoms in N Eng J Med, Lancet, BMJ |
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| Evidence Based Medicine Regarding B symptoms | Cochrane Collaboration on B symptoms • Bandolier on B symptoms • TRIP on B symptoms |
| Cost Effectiveness of B symptoms | Cost Effectiveness of B symptoms |
| Clinical Trials Involving B symptoms | Ongoing Trials on B symptoms at Clinical Trials.gov • Trial results on B symptoms • Clinical Trials on B symptoms at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding B symptoms | US National Guidelines Clearinghouse on B symptoms • NICE Guidance on B symptoms • NHS PRODIGY Guidance • FDA on B symptoms • CDC on B symptoms |
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| Genetics, Pharmacogenomics, and Proteinomics of B symptoms | Genetics of B symptoms • Pharmacogenomics of B symptoms • Proteomics of B symptoms |
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| Healthcare Provider Resources on B symptoms | Symptoms of B symptoms • Causes & Risk Factors for B symptoms • Diagnostic studies for B symptoms • Treatment of B symptoms |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
