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. 2023 Sep;25(9):2749-2758.
doi: 10.1007/s12094-023-03206-5. Epub 2023 Jun 8.

SEOM-GOTEL clinical guidelines on diffuse large B cell lymphoma (2022)

Josep Gumà #  1 , Natalia Palazón-Carrión #  2 , Antonio Rueda-Domínguez #  3 , Silvia Sequero #  4 , Virginia Calvo #  5 , Ramón García-Arroyo #  6 , José Gómez-Codina #  7 , Marta Llanos #  8 , Natividad Martínez-Banaclocha #  9 , Mariano Provencio #  5
Affiliations

SEOM-GOTEL clinical guidelines on diffuse large B cell lymphoma (2022)

Josep Gumà et al. Clin Transl Oncol. 2023 Sep.

Abstract

Diffuse large B-cell lymphoma is the most frequent histological subtype of NHL and the paradigm for the management of aggressive lymphoma. An excisional or incisional lymph node biopsy evaluated by an experienced hemopathologist is recommended to establish the diagnosis. Twenty years following its introduction, R-CHOP remains the standard first-line treatment. No modification of this scheme (increased chemotherapy dose intensity, new monoclonal antibodies, or the addition of immunomodulators or anti-target agents) has significatively improved the clinical outcomes, whereas therapy for recurrence or progression is evolving rapidly. The irruption of CART cells, polatuzumab vedotin, tafasitamab, and CD20/CD3 bispecific antibodies are changing the natural history of relapsed patients and will challenge R-CHOP as the benchmark for newly diagnosed patients.

Keywords: Diagnosis; Diffuse large B-cell lymphoma; Guideline; Treatment.

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Conflict of interest statement

JG reports Advisory Board from Incyte Biosciences and Kite-Gilead; Other from Roche. AR reports Advisory y Honoraria Speaker from Roche, BMS, MSD, Takeda, Merck and Gilead. VC reports Advisory Board from Roche, BMS, Astrazeneca and BOEHRINGER INGELHEIM; Personal Feels from Roche, BMS, MSD, Astrazeneca, Takeda, Lilly and BOEHRINGER INGELHEIM; Speaker from BMS, MSD, Astrazeneca, Takeda, Pfizer and BOEHRINGER INGELHEIM. ML reports Advisory Board from INCYTE; Speaker from ROCHE. MPP reports Advisory Board and Speaker from Roche and Takeda; Advisory Board from Incyte. NPC, NMB, JGC, RGA, SS have nothing to disclose. The current manuscript has been drafted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Figures

None
Treatment algorithm for newly diagnosed DLBCL DLBCL: diffuse large B-cell lymphoma; mIPI: stage-modified International Prognostic Index; PF: prognostic factors; R-CHOP: rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (repeat cycles at 21-day intervals); PET3: PET after the third cycle of CT; ISRT: involved-site radiotherapy.
None
Treatment algorithm for R/R DLBCL R/R DLBCL: refractory-relapsed diffuse large B-cell lymphoma; CR: complete response; PR: partial response; SD: stable disease; PD: progressive disease; HCT: hematopoietic cell transplantation; BR: rituximab, bendamustine; CAR-T: chimeric antigen receptor T-cell; R-GEMOX: rituximab, gemcitabine, oxaliplatin; R-DHAP: rituximab, cisplatin, cytarabine, dexamethasone; R-ICE: rituximab, ifosfamide, carboplatin, etoposide; R-GDP: rituximab, cisplatin, gemcitabine, dexamethasone; R-ESHAP: etoposide, methyl-prednisolone, cytarabine, cisplatin.
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