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Bone marrow transplant Chemotherapy Diffuse Large B-Cell (DLBCL) Non-Hodgkin Lymphoma Patient Stories R-EPOCH R-ICE Treatments

Nolan’s Stage 4 Diffuse Large B-cell Lymphoma (DLBCL) Story

Nolan W., T-Cell/Histiocyte-Rich Large B-Cell Lymphoma (T/HRBCL), Stage 4

Symptoms: Debilitating fatigue, flu-like symptoms without a fever, swollen lymph node under the left arm
Treatments: Chemotherapy (R-EPOCH & RICE), bone marrow transplant

Nolan’s Stage 4 Diffuse Large B-cell Lymphoma (DLBCL) Story

Interviewed by: Taylor Scheib
Edited by: Katrina Villareal

Nolan W. feature profile

Nolan was diagnosed with diffuse large B-cell lymphoma at 23, specifically a T-cell-rich subtype. Then a full-time social work student, he first noticed symptoms in late 2015, including persistent fatigue, flu-like symptoms without a fever, and a swollen lymph node under his arm. His primary care physician referred him to an oncologist after initial tests. A PET scan revealed widespread disease, indicating a more aggressive cancer than initially suspected. The diagnosis was confirmed via biopsy.

Nolan began treatment immediately due to the aggressive nature of his cancer, starting with R-EPOCH, a more intensive regimen than the standard R-CHOP, tailored to his condition. The first infusion was particularly harsh due to the high tumor burden, but subsequent treatments were more manageable. He underwent about four to five months of chemotherapy, which put him into remission by the fall of 2016. However, the cancer returned a year later, leading to salvage therapy with RICE and eventually a bone marrow transplant. The transplant was challenging, involving a severe reaction to one of the drugs, prolonged hospitalization, and intense fatigue.

The mental toll of his diagnosis and treatments was significant. While undergoing treatment, Nolan was focused on survival and had a structured routine with medical appointments and procedures. However, the period after finishing treatment was particularly difficult, as he struggled with the abrupt transition back to normal life and the fear of recurrence. The recurrence of his cancer further intensified these feelings, leading to a deep sense of uncertainty about his future.

Nolan credits his mother, a former nurse at a leukemia and lymphoma transplant center, as his primary support system. She was a crucial advocate throughout his treatment. Friends and family were supportive but sometimes distant, which he attributes partly to his reluctance to talk about his experience.

After several years of remission and moving around the country, Nolan returned to school, deciding to pursue a career in social work to help others facing serious illnesses. He reflects on how his diagnosis has profoundly affected his perspective on life. While the experience brought grief and a heightened awareness of mortality, it also instilled in him a deeper appreciation for the beauty in life’s fleeting moments. Now, Nolan feels more grounded and is cautiously optimistic about his future.


  • Name: Nolan W.
  • Age at Diagnosis:
    • 23
  • Diagnosis:
    • T-cell/histiocyte rich large B-cell lymphoma (THRLBCL)
    • Non-GCB (Germinal center B-cell)
  • Staging:
    • Stage 4
  • Symptoms:
    • Debilitating fatigue
    • Flu-like symptoms without a fever
    • Swollen lymph node under the left arm
  • Treatment:
    • Chemotherapy: R-EPOCH & RICE
    • Bone marrow transplant

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Nolan W. feature profile
Thank you for sharing your story, Nolan!

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