Article ; Online: Diffuse Large B-Cell Lymphoma and Related Entities.
Deutsches Arzteblatt international
2023 Volume 120, Issue 17, Page(s) 289–296
Abstract: Background: Diffuse large B-cell lymphoma (DLBCL) is the most common malignant B-cell neoplasm, with an incidence of 5.6 per 100 000 persons per year and a mean age of onset of approximately 65 years. It is an aggressive type of non-Hodgkin's lymphoma ... ...
| Abstract | Background: Diffuse large B-cell lymphoma (DLBCL) is the most common malignant B-cell neoplasm, with an incidence of 5.6 per 100 000 persons per year and a mean age of onset of approximately 65 years. It is an aggressive type of non-Hodgkin's lymphoma requiring urgent treatment with curative intent. Evidence-based guidelines have not been available to date. Methods: For this first international evidence-based DLBCL-specific guideline, various systematic literature searches were performed. 5 systematic reviews, 21 randomized controlled trials (RCTs), and 36 non-randomized studies were used to formulate 42 recommendations. 142 were formulated on the basis of expert consensus. All recommendations were approved in a structured consensus-finding process. Results: For staging, combined positron emission tomography and computed tomography (PET/CT) should be performed (evidence: a prospective registry study). For all patients with a new diagnosis of DLBCL and without contraindications, R-CHOP based immunochemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) should be initiated with curative intent (evidence: RCTs). The individual treatment strategy is tailored to the patient's age and risk constellation. Once immunochemotherapy has been completed, PET/CT should be performed again to check for remission. Patients with PET-positive residual disease that is amenable to radiotherapy should be treated with consolidating irradiation (evidence: retrospective cohort study). Conclusion: This clinical practice guideline on the diagnosis, treatment, and followup of patients with DLBCL and related entities provides a standardized clinical management approach, identifies areas where improvement would be desirable, and can serve as a basis for the development of further studies. |
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| MeSH term(s) | Aged ; Humans ; Antibodies, Monoclonal, Murine-Derived/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Lymphoma, Large B-Cell, Diffuse/therapy ; Lymphoma, Large B-Cell, Diffuse/drug therapy ; Prednisone/therapeutic use ; Rituximab/therapeutic use ; Vincristine/therapeutic use |
| Chemical Substances | Antibodies, Monoclonal, Murine-Derived ; Cyclophosphamide (8N3DW7272P) ; Doxorubicin (80168379AG) ; Prednisone (VB0R961HZT) ; Rituximab (4F4X42SYQ6) ; Vincristine (5J49Q6B70F) |
| Language | English |
| Publishing date | 2023-03-21 |
| Publishing country | Germany |
| Document type | Journal Article ; Practice Guideline |
| ZDB-ID | 2406159-1 |
| ISSN | 1866-0452 ; 1866-0452 |
| ISSN (online) | 1866-0452 |
| ISSN | 1866-0452 |
| DOI | 10.3238/arztebl.m2023.0035 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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