Current treatment strategy of diffuse large B-cell lymphomas

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin's lymphoma, accounting for approximately 25-30% of all new patients. Rituximab, a genetically engineered chimeric monoclonal antibody that specifically binds to CD20, is the first monoclonal antibody approved for the treatment of B-cell lymphoma. Rituximab significantly improves treatment outcome in DLBCL. A large-phase III study demonstrated improved overall survival (OS) in patients with DLBCL treated with R-CHOP therapy. The Groupe d'Etude des Lymphomes de l'Adulte (GELA), Eastern Cooperative Oncology Group (ECOG) and German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL) studies designed for patients older than 60 years have clearly shown prolonged event-free survival (EFS) and OS among patients who received rituximab and chemotherapy. For patients under 60 years, the MabThera International Trial Group (MInT) study demonstrated improved EFS and OS after the addition of rituximab to CHOP therapy. However, the R-CHOP therapy does not provide a satisfactory treatment outcome in the high-risk group according to the international prognostic index. Therefore, R-CHOP therapy is the new standard therapy in elderly and young, low-risk DLBCL patients. For young, high-risk DLBCL patients, treatment that incorporates rituximab and hematopoietic stem cell transplantation has been administered in clinical studies.