Diffuse large B cell lymphoma risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anila Hussain, MD [2] Sowminya Arikapudi, M.B,B.S. [3]


There are several factors including family history, old age, male gender, white ethnicity, geography, certain viruses, exposure to certain drugs and chemicals, radiation exposure, autoimmune diseases, and weak immune system that can increase the chances of getting Non-Hodgkin Lymphoma (NHL). Diffuse Large B cell Lymphoma ((DLBC) is the most common sub-type[1][2][3][4].On the other hand, factors that are associated with a decreased risk of DLBCL include blood transfusion, alcohol consumption, vegetables consumption, sun exposure, and allergies.

Risk factors:

Factors that increase the risk:

Family History:

Genetic susceptibility is an important risk factor. TNF/LTA; 6p25.3; 6p21.33; 2p23.3; 8q24-21 loci have been identified.


Old age is a strong risk factor for lymphoma with the majority of cases occurring at age 60 or more; however, some cases can be seen in young population depending upon the type of Lymphoma


The overall risk of Non-Hodgkin Lymphoma is higher in men than in women, but there are certain types that are more commonly seen in women. Reasons for this finding are unknown.

Race, Ethnicity and Geography:

In the USA, Non-Hodgkin Lymphoma is most commonly seen in white population than African-Americans or Asian-Americans

Worldwide, it is more common in developed countries with USA and Europe having the highest prevalence.


Some viruses can increase the risk such as HIV, EBV, HHV-8, HBV, and HCV.

Drug and Chemical Exposure:

Some chemicals like Benzene and Herbicides and Insecticides may be associated with an increased risk of NHL but research is in progress to clarify these links. Some chemotherapeutic drugs might be associated as a treatment for Hodgkin Lymphoma increases the risk of NHL but it is unclear whether it is treatment related or related to disease itself.


There is an increased risk of many types of cancers in people exposed to high intensity. It has been reported that survivors of several nuclear reactor accidents and atomic bombs tend to have certain types of cancers including NHL, Leukemia and Thyroid cancer. Also, people with Hodgkin Lymphoma who get treated with radiotherapy have a slightly increased incidence to develop NHL later in life.


There is an increased risk of NHL in people with immunodeficiency. Examples include organ transplant recipients who are on immunosuppressive drugs, HIV Infection. Some genetic conditions in which children are born with weak immune system like Wiskott-Aldrich Syndrome and Ataxia-telengectasia(AT) also have a higher risk of NHL. However, type 2 diabetes mellitus has no significant effect.


Some autoimmune diseases also increase the risk slightly such as Sjogren syndrome, celiac disease, and SLE.

Factors that decrease the risk:

Blood transfusion, alcohol consumption, vegetables consumption, sun exposure, and allergies are associated with decreased risk of developing DLBCL.[5]


  1. DeVita, Vincent T., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's cancer : principles & practice of oncology. Philadelphia: Wolters Kluwer, 2011. Print.
  2. Hartge P, Smith MT. Environmental and behavioral factors and the risk of non-Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev. 2007;16:367-368.
  3. Roschewski MJ, Wilson WH. Chapter 106: Non-Hodgkin Lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier; 2014.
  4. Kushi LH, Doyle C, McCullough M, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62:30-67.
  5. Sehn LH, Salles G (2021). "Diffuse Large B-Cell Lymphoma". N Engl J Med. 384 (9): 842–858. doi:10.1056/NEJMra2027612. PMID 33657296 Check |pmid= value (help).

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