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Review
. 2023 Aug;12(4):145-160.
doi: 10.14740/jh1112. Epub 2023 Aug 31.

Harnessing the Immune System: An Effective Way to Manage Diffuse Large B-Cell Lymphoma

Nathan Visweshwar  1 , Juan Felipe Rico  2 , Robert Killeen  3 , Arumugam Manoharan  4
Affiliations
Review

Harnessing the Immune System: An Effective Way to Manage Diffuse Large B-Cell Lymphoma

Nathan Visweshwar et al. J Hematol. 2023 Aug.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is a heterogenous hematological disorder with malignant potential controlled by immunological characteristics of the tumor microenvironment. Rapid breakthrough in the molecular pathways has made immunological approaches the main anchor in the management of DLBCL, with or without chemotherapeutic agents. Rituximab was the first monoclonal antibody approved for the treatment of DLBCL. Following rituximab that transformed the therapeutic landscape, other novel immunological agents including chimeric antigen T-cell therapy have reshaped the management of relapsed/refractory DLBCL. However, resistance and refractory state remain a challenge in the management of DLBCL. For this literature review, we screened articles from Medline, Embase, Cochrane databases and the European/North American guidelines from March 2010 through October 2022 for DLBCL. Here we discuss immunological agents that will significantly affect future treatment of this aggressive type of lymphoma.

Keywords: Antibody drug conjugates; Bispecific T-cell engager antibody; Checkpoint inhibitors; Chimeric antigen receptor T-cell therapy; Diffuse large B-cell lymphoma; Immunomodulatory therapy; Immunotherapy.

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Conflict of interest statement

NV has been on the advisory board of Biogen Idec. Other authors declare there is no conflict of interest in writing this manuscript.

Figures

Figure 1
Figure 1
Immunological targets in DLBCL. DLBCL: diffuse large B-cell lymphoma.
Figure 2
Figure 2
Effects of immunomodulatory agents.
Figure 3
Figure 3
Monoclonal antibodies.
Figure 4
Figure 4
Targeting macrophages with anti-CD47 antibody (magrolimab).
Figure 5
Figure 5
Antibody-drug conjugate.
Figure 6
Figure 6
CARs and tumor cell interaction. CARs: chimeric antigen receptor T cells.
See this image and copyright information in PMC

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