B symptoms

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The B symptoms (a.k.a. inflammatory symptoms) are a triad of systemic symptoms associated with more advanced disease and a poorer outcome in lymphoma :

  • weight loss
    • >10% unintentional decrease in body weight in the 6 months preceding the diagnosis
  • fever: >38°C
  • night sweats

B symptoms are a poor prognostic factor in lymphoma (both Hodgkin and non-Hodgkin lymphomas). For this reason, if there are B symptoms, then the tumor is upstaged under the Lugano classification system. The presence of B symptoms correlates well with an elevated level of inflammatory cytokines in body fluids .

History and etymology

In the Rye staging system for Hodgkin disease, agreed in 1966, each stage was subclassified as A or B, according to the absence (A) or presence (B) of symptoms. In the Rye system the B symptoms were fever, night sweats and pruritus. In the Ann Arbor staging system introduced in 1971, which updated and superseded the Rye system, pruritus was dropped as a B symptom and replaced with weight loss .