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.
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:
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]
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]
Similar systemic symptoms can be found in non-cancerous states such as tuberculosis and various inflammatoryorrheumatologic 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.
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