2021 Update on Diffuse large B cell lymphoma: A review of current data and potential applications on risk stratification and management

Am J Hematol. 2021 May 1;96(5):617-629. doi: 10.1002/ajh.26151. Epub 2021 Mar 19.

Abstract

Diffuse large B cell lymphoma (DLBCL), the most common type of Non-Hodgkin lymphoma (NHL), comprises a heterogeneous group of diseases with different biology, clinical presentations, and response to treatment. R-CHOP remains the mainstay of therapy and can achieve long-term disease control in nearly 90% of patients presenting with limited-stage and in up to 60% of those presenting with advanced stages. Advances on the understanding of the genetic landscape and molecular features of DLBCL have identified high-risk subsets with poor outcomes to chemo-immunotherapy that are actively being studied in clinical trials. Novel therapies could potentially improve outcomes for patients with high-risk disease. Studies evaluating risk-adapted therapy based on classification by cell of origin (COO) and molecular features are ongoing. Developments in the fields of immunotherapy, mostly with adoptive T-cell therapy, have significantly improved the outcomes of patients with relapsed refractory disease. In this review, we will summarize the recent data and discuss ongoing efforts to improve DLBCL treatment in the frontline and relapsed refractory settings.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • B-Lymphocyte Subsets / pathology
  • Cell Lineage
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • DNA, Neoplasm / blood
  • Disease Management
  • Doxorubicin / administration & dosage
  • Exome Sequencing
  • Genes, bcl-2
  • Genes, myc
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunotherapy, Adoptive
  • Lymphoma, Large B-Cell, Diffuse* / classification
  • Lymphoma, Large B-Cell, Diffuse* / genetics
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Neoplasm Staging
  • Neoplastic Stem Cells / pathology
  • Positron Emission Tomography Computed Tomography
  • Prednisone / administration & dosage
  • Recurrence
  • Risk Assessment
  • Rituximab / administration & dosage
  • Salvage Therapy
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • DNA, Neoplasm
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol