**7. Staging, prognosis, and treatment**

The Ann Arbor staging classification (**Table 2**) which was developed for HD in 1971, has been the standard scheme for NHL [69, 70]; however, it does not account for tumor burden and does not correlate well with prognosis. The Prognosis and


#### **Table 2.**

*The Ann Arbor staging classification.*


**67**

*B-Cell Lymphomas*

groups in NHL.

**8. Conclusion**

managing with targeted therapies.

Authors declare no conflict of interest.

**Conflict of interest**

*DOI: http://dx.doi.org/10.5772/intechopen.87370*

genase (LDH) level, number of extranodal sites, etc.

treatment depends not only on the stage but also on a variety of clinical parameters that reflect tumor bulk and kinetics including the size of the mass, lactate dehydro-

The international prognostic index (IPI) (**Table 3**) was developed to correlate clinical parameters with prognosis and appears to be more useful than the Ann Arbor staging system in predicting survival. Studies have indicated that the IPI correlates with prognosis for all histologies [71–73]. Additional biologic and genetic parameters, particularly genomic profiling, further subdivide prognostic

Therapy follows the assessment of the patient, the pathology, and the stage of the disease. The ability of the patient to tolerate therapy is dependent on age, performance status, and, if present, immunodeficiency due to a prelymphomatous condition. Various treatment modalities include observation, radiotherapy for localized disease, chemotherapy, immunotherapy, and stem cell transplantations.

B-cells though plays a major role in humoral immunity can also lead to various pathologic diseases. B-cell lymphomas are malignant neoplasms that arise from various stages of differentiation of B-cells which are classified based on the cell of origin and behavior. Historically, there has been much controversy in the classification of lymphoid neoplasms, but consensus has been reached through the use of objective molecular diagnostic tools. The current WHO classification uses morphologic, immunophenotypic, genotypic, and clinical features to classify the lymphoid neoplasms into five broad categories as precursor B-cell neoplasms, peripheral B-cell neoplasms, precursor T-cell neoplasms, peripheral T-cell neoplasms and Hodgkin lymphoma. B-cell lymphomas include precursor B-cell neoplasms and peripheral B-cell neoplasms. Hodgkin lymphoma though originates from B-cell has distinctive pathologic features and is treated as a separate entity. B-cell lymphomas range in their clinical behavior from low grade to high grade and also have histological or clinical progression during a patient's clinical course. For these reasons, the WHO classification does not attempt to stratify lymphoid malignancies in terms of grade. Also both morphology and immunophenotype often change over time with the acquisition of additional genetic changes. Hence B-Cell lymphomas are expanding with emerging new entities due to its wide molecular/genetic landscape and are being revised frequently for better understanding and diagnosis which helps in

**Table 3.** *International Prognostic Index.*

#### *B-Cell Lymphomas DOI: http://dx.doi.org/10.5772/intechopen.87370*

treatment depends not only on the stage but also on a variety of clinical parameters that reflect tumor bulk and kinetics including the size of the mass, lactate dehydrogenase (LDH) level, number of extranodal sites, etc.

The international prognostic index (IPI) (**Table 3**) was developed to correlate clinical parameters with prognosis and appears to be more useful than the Ann Arbor staging system in predicting survival. Studies have indicated that the IPI correlates with prognosis for all histologies [71–73]. Additional biologic and genetic parameters, particularly genomic profiling, further subdivide prognostic groups in NHL.

Therapy follows the assessment of the patient, the pathology, and the stage of the disease. The ability of the patient to tolerate therapy is dependent on age, performance status, and, if present, immunodeficiency due to a prelymphomatous condition. Various treatment modalities include observation, radiotherapy for localized disease, chemotherapy, immunotherapy, and stem cell transplantations.
