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Posted by on Mar 31, 2019 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This article reviewed treatment options for patients with diffuse large B-cell lymphoma (DLBCL).

Some background

DLBCL is one of the most common types of non-Hodgkin's lymphoma (NHL). Chemoimmunotherapy is the typical first-line treatment for patients with NHL. R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) is the most commonly used regimen. This regimen is very effective in 50 to 60% of patients. However, some patients develop disease that stops responding to treatment or experience cancer recurrence. New treatment options are needed for these patients.

Methods & findings

For patients with previously untreated DLBCL, R-CHOP remains the standard of care. R-CHOP may be combined with targeted therapies such as lenalidomide (Revlimid). These agents specifically target cancer cells without affecting healthy cells. This leads to fewer side effects.

In one study, 98% of patients treated with lenalidomide plus R-CHOP responded to treatment. 80% of patients had a complete disappearance of all signs of cancer. More studies with this regimen are ongoing. In another study, patients treated with intensive chemoimmunotherapy survived for much longer without tumor growth or spread compared to patients treated with R-CHOP alone (21.6 months vs. 7.8 months).

For patients whose cancer comes back or stops responding to treatment, stem cell transplantation is the next step. In one study, 37% of patients on average were still alive after the transplant without tumor growth or spread. However, patients whose cancer returns within a year of transplantation tend to have poor outcomes.

In one study, 45 patients with recurring or non-responsive DLBCL were treated with lenalidomide plus rituximab (Rituxan). 33% of patients responded to treatment. At follow-up, patients remained alive for an average of 10.7 months after treatment. In another study, 48 patients received lenalidomide alone. On average, 70% of patients were still alive without tumor growth or spread at 1 year.

New biological therapies for patients with recurring or non-responsive DLBCL remain under investigation.

The bottom line

This article reviewed treatment options for patients with DLBCL. Research into new therapies for patients with cancer that has returned or stopped responding to treatment remains ongoing.

Published By :

American Journal of Hematology

Date :

Mar 11, 2019

Original Title :

Diffuse Large B cell Lymphoma: 2019 update on diagnosis, risk-stratification and treatment.

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