Non-Hodgkin Lymphoma Biomarkers
CD20 status is the first biomarker checked in most B-cell lymphomas — CD20-positive tumors respond to rituximab, one of the most successful targeted cancer therapies in medical history.
Reviewed by XpertPatient Medical Advisory · Updated June 2026 · Sources: NCI · ACS · ASCO · NIH/PMC
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What is a biomarker?
A biomarker in lymphoma is usually a protein on the surface of cancer cells, or a specific gene change inside them. The most important surface protein is CD20 — it’s found on most B-cell lymphomas and is the target of one of the most successful cancer drugs ever made: rituximab.
Non-Hodgkin lymphoma includes over 60 different cancer types. Biomarker testing is essential to identify exactly which type you have — because each one behaves differently and responds to different treatments.
What this means for you: The first question in lymphoma is always: what kind? CD20 status, cell-of-origin, and chromosome changes together answer that — and shape your entire treatment plan.
The Tests Your Doctor Orders
🔍 Does your lymphoma have a surface protein that a targeted drug can attach to?
CD20 is found on most B-cell lymphomas. Rituximab (Rituxan) attaches to CD20 and helps your immune system destroy those cells. Combined with chemotherapy (R-CHOP), it has dramatically improved outcomes for most B-cell lymphoma patients.
🔍 Is a protein that helps cancer survive overactive?
BCL2 helps cancer cells live longer than they should. In some lymphomas it can be directly targeted by venetoclax. BCL2 overexpression also defines one subtype of aggressive lymphoma called double-hit lymphoma.
🔍 Is there a chromosome change that signals aggressive disease?
When MYC and BCL2 are both rearranged, it creates ‘double-hit lymphoma’ — one of the most aggressive subtypes. Standard R-CHOP doesn’t work well for double-hit; more intensive regimens are used instead.
Sources: LLS · Lymphoma Research Foundation · NCI
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Common Questions
Non-Hodgkin Lymphoma Biomarkers — Your Questions Answered
What is the difference between slow-growing and fast-growing lymphoma?
Slow-growing (indolent) lymphomas like follicular lymphoma may not need immediate treatment. Fast-growing (aggressive) lymphomas like DLBCL need treatment soon. Biomarker testing determines which type you have.
What is R-CHOP?
The standard first-line treatment for most aggressive B-cell lymphomas. It combines rituximab with four chemotherapy drugs, given in cycles every 3 weeks.
What is CAR-T therapy for lymphoma?
CAR-T therapy takes your own immune cells, modifies them to attack lymphoma cells, then puts them back in your body. It’s FDA-approved for relapsed or refractory large B-cell lymphoma that didn’t respond to initial treatment.
What is double-hit lymphoma?
Lymphoma with rearrangements of both MYC and BCL2. It’s more aggressive and doesn’t respond well to standard R-CHOP. More intensive treatment and clinical trials are typically recommended.
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