Management of Lymphomas: Consensus Document 2018 by an Indian Expert Group

Abstract

The clinical course of lymphoma depends on the indolent or aggressive nature of the disease. Hence, the optimal management of lymphoma needs a correct diagnosis and classification as B cell, T-cell or natural killer (NK)/T-cell as well as indolent or high-grade type lymphoma. The current consensus statement, developed by experts in the field across India, is intended to help healthcare professionals manage lymphomas in adults over 18 years of age. However, it should be noted that the information provided may not be appropriate to all patients and individual patient circumstances may dictate alternative approaches. The consensus statement discusses the diagnosis, staging and prognosis applicable to all subtypes of lymphoma, and detailed treatment regimens for specific entities of lymphoma including diffuse large B-cell lymphoma, Hodgkin's lymphoma, follicular lymphoma, T-cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, Burkitt's lymphoma, and anaplastic large cell lymphoma.

Keywords: Common regimens; Consensus statement; Lymphoma; Management.

Fig. 1

Treatment algorithm of Primary CNS lymphoma (PCNSL). Ara-c cytarabine, CR complete response, MRI magnetic resonance imaging, PD progressive disease, PR partial response, R-MPV rituximab, methotrexate, procarbazine, and vincristine, SD stable disease, WBRT whole brain radiation therapy

Fig. 2

Treatment for Stage II E Primary Testicular Lymphoma (PTL). Four doses of intrathecal methotrexate (starting on day 1 of cycle I R-CHOP)

Fig. 3

Management algorithm for relapsed lymphoma. HSCT hematopoietic stem cell transplant, DHAP dexamethasone, high dose cytosine arabinoside, cisplatin, ICE ifosphamide, carboplatin, etoposide, MINE mesna, ifosphamide, mitroxantrone, etoposide