Quick answer: Diffuse large B-cell lymphoma (DLBCL) is a fast-growing cancer of B-lymphocytes, a type of white blood cell. It is the most common type of non-Hodgkin lymphoma, and the American Cancer Society says it can be cured in more than half of all patients. The usual first treatment is R-CHOP. If the lymphoma comes back after two or more treatments, newer options include CAR T-cell therapy and bispecific antibodies such as Columvi (glofitamab), which a doctor in India can request for a patient through a Named Patient Program.
Last reviewed: 2 November 2026. Every figure in this guide is sourced in the References section.
"Is It Curable?" Is Usually the First Question
When a biopsy report says "diffuse large B-cell lymphoma", most families hear only one word: cancer. The next question, often asked before anything else, is whether it can be cured.
For many people, the honest answer is yes. DLBCL grows quickly, which sounds frightening, but fast-growing lymphomas also tend to respond well to treatment. The American Cancer Society says DLBCL can be cured in more than half of all patients, and that the stage and a risk score called the International Prognostic Index (IPI) make a big difference to the odds.
This guide walks you through the signs, the tests, the usual order of treatment, and what happens if the lymphoma comes back. It also explains where newer medicines like Columvi come in, and how patients in India can get a medicine that isn't sold here through the regulated named patient import route.
DLBCL at a Glance
| What it is | A fast-growing B-cell non-Hodgkin lymphoma |
| How common | About 1 in 3 lymphomas; the most common NHL type in the US |
| Typical age | Median age at diagnosis 67 (US SEER data) |
| Common first sign | A painless lump that keeps growing in the neck, armpit or groin |
| How it is confirmed | Biopsy of the lymph node or affected tissue |
| Usual first treatment | R-CHOP (rituximab plus four chemotherapy drugs), in 3-week cycles |
| If it comes back | CAR T-cell therapy, more chemo with stem cell transplant, or bispecific antibodies |
| 5-year relative survival | 64.8% overall (SEER, 2016–2022) |
How Many People Does DLBCL Affect?
India's cancer registries report non-Hodgkin lymphoma as a whole rather than DLBCL on its own, so the India figures below are for all NHL. The US figures are specific to DLBCL.
In India (GLOBOCAN 2024)
- 41,973 new cases of non-Hodgkin lymphoma in a year, the 11th most common cancer in the country
- 23,769 deaths from non-Hodgkin lymphoma in the same year
- 1,04,927 people living with NHL diagnosed in the past 5 years
Worldwide (GLOBOCAN 2024)
- 5,62,793 new cases and 2,34,903 deaths from non-Hodgkin lymphoma
- Asia accounts for 44.5% of new cases
DLBCL in the United States (NCI SEER)
- New cases: 5.6 per 1,00,000 people a year; deaths: 1.7 per 1,00,000 (2019–2023)
- Most often diagnosed between ages 65 and 74; median age 67
- 40% of people are diagnosed at stage IV, the most widespread stage
5-year relative survival by stage at diagnosis (SEER)
Survival numbers describe large groups of people diagnosed years ago. They can't tell you what will happen to one person, and treatments have changed since many of these patients were treated.
Signs That Deserve a Doctor's Visit
DLBCL often starts as a lump in a lymph node that grows fast. It can also begin in other organs, such as the intestines, bones, brain or spinal cord, so symptoms vary a lot from person to person.
A lump that doesn't hurt and doesn't go away
Most swollen lymph nodes come from infections. Those usually hurt when you press them and shrink once the infection settles. A lymphoma node is different:
- It usually doesn't hurt
- It keeps getting bigger over weeks
- New lumps may show up somewhere else, such as above the collarbone, in the armpit or in the groin
"B symptoms"
Doctors pay special attention to three symptoms, because they also affect staging:
- Fever that comes and goes over days or weeks, with no infection to explain it
- Drenching night sweats
- Losing at least 10% of your body weight over 6 months without trying
Symptoms that depend on where it grows
- Belly: swelling or pain, feeling full after a small meal, nausea or vomiting
- Chest: cough, breathlessness, chest pain or pressure
- Other signs: deep tiredness, frequent or severe infections, easy bruising or bleeding
When it is an emergency
A lymphoma in the chest can press on the large vein that brings blood back from the head and arms (the superior vena cava). Swelling of the face, neck or arms with breathing trouble needs emergency care the same day.
Who Is More Likely to Get It?
Most people with non-Hodgkin lymphoma have no risk factor they could have changed. Nobody "caused" it by what they ate or did. Known risk factors include:
- Older age
- A weakened immune system, for example after an organ transplant or with HIV
- Some autoimmune diseases
- Certain infections
- Earlier radiation or some chemotherapy drugs
- Family history, and possibly excess body weight
How Doctors Confirm DLBCL
A blood test alone can't diagnose lymphoma. The diagnosis needs tissue.
The biopsy
The surgeon removes all or part of a lymph node (excisional or incisional biopsy), or takes a sample with a needle. In the lab, specialists look at the cells under the microscope and run tests such as flow cytometry and immunohistochemistry to confirm the B-cell type.
Working out the stage
- PET/CT scan to see where the lymphoma is in the body
- Blood tests such as a complete blood count and LDH, which help show how active the disease is
- In some people, a bone marrow biopsy or a lumbar puncture (spinal fluid test)
- Heart tests before treatment if the chemotherapy plan includes drugs that can affect the heart
Treatment, Step by Step
The first treatment
For most people, treatment starts with R-CHOP: the antibody rituximab plus four chemotherapy drugs (cyclophosphamide, doxorubicin, vincristine and prednisone). It is usually given in cycles three weeks apart. A PET/CT scan after a few cycles shows how well it is working and helps decide how much more treatment is needed. People with heart problems or other serious health issues may get a different chemo combination.
If it doesn't go away, or comes back
What happens next depends mostly on timing.
- Comes back within about a year (or never fully goes away): more chemo is less likely to work, and CAR T-cell therapy is often the preferred next step
- Comes back later: doctors usually try a different chemo regimen, followed by a stem cell transplant if the lymphoma shrinks and the person is fit enough
When several treatments have already been tried
For DLBCL that keeps returning, options include bispecific antibodies such as epcoritamab or glofitamab, other antibodies and antibody-drug conjugates, targeted drugs and clinical trials. Glofitamab is the medicine sold as Columvi. Several of these newer medicines are not sold in India yet, and you can see the ones we help families import on our blood cancer and haematology medicines list.
Where Columvi Fits
What Columvi is
Columvi (glofitamab-gxbm), made by Genentech, part of the Roche Group, is a bispecific antibody. One arm grabs CD20, a marker on the lymphoma B-cells. The other arm grabs CD3 on your own T-cells. By holding the two together, it points your immune cells straight at the cancer. It is not chemotherapy.
The US FDA gave Columvi accelerated approval on 15 June 2023. It is approved for adults with DLBCL (not otherwise specified), or large B-cell lymphoma that grew out of follicular lymphoma, which has come back or stopped responding after two or more lines of treatment.
What the trial showed
The approval was based on Study NP30179, in which 132 adults received Columvi. These were hard-to-treat cases: the median patient had already had 3 earlier treatments, 83% had lymphoma that wasn't responding to their last treatment, and 30% had already received CAR T-cell therapy.
- 56% had their lymphoma shrink (overall response rate)
- 43% had a complete response, meaning no visible lymphoma on scans
- Responses lasted a median of 18.4 months
- The median time to the first response was 42 days
Because the approval is based on response rates, the FDA has asked for confirmatory trials to show the clinical benefit. That's normal for an accelerated approval, and worth knowing.
How it is given
- Day 1: one dose of another antibody, obinutuzumab 1,000 mg, to lower the risk of a strong immune reaction
- Day 8: first small Columvi dose, 2.5 mg
- Day 15: second step-up dose, 10 mg
- Cycles 2 to 12: 30 mg on day 1 of each 21-day cycle
Everything is given as a drip into a vein, in a hospital set up to manage side effects. The label says patients should stay in hospital for 24 hours after the first 2.5 mg dose.
Side effects to know about
Cytokine release syndrome (CRS)
This is the main risk and the reason for the step-up schedule. CRS is an over-strong immune reaction. In the trial it happened in 70% of patients, mostly mild (grade 1 in 52%), but it can be serious or fatal, which is why it carries a boxed warning. It was most common after the first 2.5 mg dose.
Signs to report straight away
- Fever of 38°C (100.4°F) or higher
- Chills or shaking
- Fast or irregular heartbeat
- Dizziness or light-headedness
- Trouble breathing
Other warnings
- Neurologic problems such as headache, nerve pain, dizziness or confusion
- Serious infections, which were reported in 16% of patients
- Tumour flare: pain and swelling where the lymphoma is, usually in the first cycle
- Harm to an unborn baby
The most common side effects apart from CRS were muscle and bone pain, rash and tiredness.
Getting Columvi in India
If your haematologist decides glofitamab is right for you, the medicine can be imported for you as an individual patient. NPP handles the paperwork for Columvi in India, including the import permission and cold-chain shipping, because the vials must stay between 2°C and 8°C.
Questions Worth Taking to Your Next Appointment
- What stage is my lymphoma, and what is my IPI score?
- How many cycles of R-CHOP do you plan, and when will the PET/CT check happen?
- Do I need heart tests before chemotherapy?
- If the lymphoma comes back, would CAR T-cell therapy or a bispecific antibody be the next option for me?
- Am I eligible for a clinical trial?
Frequently Asked Questions
Can DLBCL be cured?
Yes, often. The American Cancer Society says DLBCL can be cured in more than half of all patients. The chances are better at lower stages and with a lower IPI score.
Is DLBCL a type of leukaemia?
No. DLBCL is a lymphoma, which mostly grows in lymph nodes and other organs. Leukaemias start in the bone marrow and blood. Our guide to acute lymphoblastic leukaemia explains how that disease is different.
Is Columvi chemotherapy?
No. Columvi is a bispecific antibody, a kind of immunotherapy that links your T-cells to the lymphoma cells. It is used after two or more earlier treatments, not as the first treatment.
Is Columvi available in India?
It can be imported for an individual patient through a regulated Named Patient Program once a haematologist or oncologist prescribes it. Our team sorts out the import documents and delivery.
What is the Columvi price in India?
The cost depends on the number of vials your treatment plan needs and the current import cost, so there is no single fixed figure. Share the prescription with us for an exact quote. You can also start a Columvi price in India enquiry straight from the product page.
Why go through NPP and not any online seller?
Fake or badly stored biologic medicines can look exactly like the real thing from the outside, and Columvi has to stay refrigerated and must never be frozen. Through NPP, the medicine comes from authorised sources with full import paperwork and batch traceability, so you know what is going into the drip.
Talk to Our Team
Every family's situation is a little different. Some are still deciding with their doctor, others already have a prescription in hand. If you or someone you care for has DLBCL that has come back after treatment, and the doctor has mentioned glofitamab, send us the prescription. We'll explain the steps, documents and timeline in plain language, with no pressure.
This guide is for information only and is not medical advice. Treatment decisions should be made with a qualified haematologist or oncologist.
References
- American Cancer Society: Types of B-Cell Lymphoma
- American Cancer Society: Treating B-Cell Non-Hodgkin Lymphoma
- American Cancer Society: Signs and Symptoms of Non-Hodgkin Lymphoma
- American Cancer Society: Tests for Non-Hodgkin Lymphoma
- American Cancer Society: Non-Hodgkin Lymphoma Causes, Risk Factors, and Prevention
- National Cancer Institute SEER: Cancer Stat Facts, Diffuse Large B-Cell Lymphoma
- IARC GLOBOCAN 2024: India fact sheet
- IARC GLOBOCAN 2024: Non-Hodgkin lymphoma fact sheet
- DailyMed: Columvi (glofitamab-gxbm) prescribing information, Genentech (revised June 2026)
- ClinicalTrials.gov: Study NP30179 of glofitamab in relapsed/refractory B-cell non-Hodgkin lymphoma (NCT03075696)
