{"entity":{"id":"lymphoma-b-versus-t-cell","kind":"term","name":"B-cell, T-cell and NK-cell lymphoma","aka":["B-cell lymphoma","T-cell lymphoma","NK-cell lymphoma","cell of origin","lineage"],"tldr":"The first thing a lymphoma report says is which kind of lymphocyte the cancer came from. B cells make antibodies and carry a surface protein called CD20; T and NK cells kill infected cells directly and carry no CD20. That single difference is why B-cell lymphomas have had thirty years of new antibody treatments and T-cell lymphomas have not.","summary":"Lymphocytes come in three lineages and a lymphoma inherits the one it arose from. B cells mature in the bone marrow and in the germinal centres of lymph nodes, and make antibodies. T cells mature in the thymus and either help other immune cells or kill infected ones. Natural killer cells kill without needing to recognise a specific antigen, and share many surface proteins with cytotoxic T cells, which is why the classifications treat T-cell and NK-cell lymphomas as one group.\n\nThe proportions are lopsided. In the UK Haematological Malignancy Research Network series of 5,796 lymphomas, 94.7 per cent were B-cell and 5.3 per cent T-cell. The outcomes are lopsided in the same direction: five-year relative survival was 68.8 per cent for the B-cell group and 45.4 per cent for the T-cell group.\n\nThe reason is mostly pharmacological rather than biological. B cells carry CD20, a protein with no essential function that the body can do without, so an antibody against it can be given safely and kills the lymphoma along with the normal B cells. Rituximab was licensed in 1997 and every later B-cell treatment, from antibody-drug conjugates to CAR-T to bispecific antibodies, built on the same idea of a surface address. T cells have no equivalent: the obvious targets are proteins the healthy T cells need, so removing them removes the immune system, and a CAR-T cell aimed at a T-cell protein attacks the other CAR-T cells, a problem called fratricide that the engineering is only now starting to solve.\n\nOn a report, the lineage is read from immunohistochemistry: CD20, CD79a and PAX5 for B cells, CD3, CD2, CD5 and CD7 for T cells, CD56 and cytoplasmic CD3 for NK cells. A clonal rearrangement of the immunoglobulin or T-cell receptor genes confirms that the population is a single clone rather than a reaction.","asOf":"2026-09-29","links":[{"label":"WHO Classification of Haematolymphoid Tumours, 5th edition: lymphoid neoplasms (Alaggio, Leukemia 2022)","url":"https://doi.org/10.1038/s41375-022-01620-2"},{"label":"Lymphoma incidence, survival and prevalence 2004 to 2014, subtype analyses from the UK Haematological Malignancy Research Network (Smith, Br J Cancer 2015)","url":"https://doi.org/10.1038/bjc.2015.94"}],"tags":["heme","lymphoma"],"related":["lymphoma-type","lymphoma-classification-2022","cd20"],"cancers":["non-hodgkin-lymphoma","dlbcl","peripheral-t-cell-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":["rituximab","brentuximab-vedotin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Biomarkers"},"route":"/terms/lymphoma-b-versus-t-cell/","neighbours":{"term":[{"id":"lymphoma-type","kind":"term","name":"Lymphoma (tissue type)","route":"/terms/lymphoma-type/"},{"id":"lymphoma-classification-2022","kind":"term","name":"The two lymphoma classifications of 2022 (WHO-HAEM5 and ICC)","route":"/terms/lymphoma-classification-2022/"}],"target":[{"id":"cd20","kind":"target","name":"CD20","route":"/targets/cd20/"}],"cancer":[{"id":"adult-t-cell-leukaemia-lymphoma","kind":"cancer","name":"Adult T-cell leukaemia/lymphoma","route":"/cancers/adult-t-cell-leukaemia-lymphoma/"},{"id":"alk-negative-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-negative anaplastic large cell lymphoma","route":"/cancers/alk-negative-anaplastic-large-cell-lymphoma/"},{"id":"alk-positive-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-positive anaplastic large cell lymphoma","route":"/cancers/alk-positive-anaplastic-large-cell-lymphoma/"},{"id":"breast-implant-associated-alcl","kind":"cancer","name":"Breast implant-associated anaplastic large cell lymphoma","route":"/cancers/breast-implant-associated-alcl/"},{"id":"cutaneous-t-cell-lymphoma","kind":"cancer","name":"Cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome)","route":"/cancers/cutaneous-t-cell-lymphoma/"},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"ebv-positive-dlbcl","kind":"cancer","name":"EBV-positive diffuse large B-cell lymphoma","route":"/cancers/ebv-positive-dlbcl/"},{"id":"extranodal-nk-t-cell-lymphoma","kind":"cancer","name":"Extranodal NK/T-cell lymphoma","route":"/cancers/extranodal-nk-t-cell-lymphoma/"},{"id":"hodgkin-lymphoma","kind":"cancer","name":"Hodgkin lymphoma","route":"/cancers/hodgkin-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"peripheral-t-cell-lymphoma","kind":"cancer","name":"Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)","route":"/cancers/peripheral-t-cell-lymphoma/"},{"id":"plasmablastic-lymphoma","kind":"cancer","name":"Plasmablastic lymphoma","route":"/cancers/plasmablastic-lymphoma/"},{"id":"t-cell-histiocyte-rich-large-b-cell-lymphoma","kind":"cancer","name":"T-cell/histiocyte-rich large B-cell lymphoma","route":"/cancers/t-cell-histiocyte-rich-large-b-cell-lymphoma/"}],"drug":[{"id":"brentuximab-vedotin","kind":"drug","name":"Brentuximab vedotin","route":"/drugs/brentuximab-vedotin/"},{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"}]}}