Recent advances in the understanding of aggressive B-cell lymphomas

Abstract

Aggressive lymphomas are tumours that have a progressive clinical course but may potentially be curable by chemotherapy. This review will focus on diffuse large B-cell lymphoma and Burkitt lymphoma as archetypal aggressive lymphomas. One of the main challenges is to be able to accurately assess a patient's prognosis at the time of first presentation to allow selection of the most appropriate treatment and to provide accurate information to the patient. Recently, it has become clear that prognosis is determined by the tumour's state of differentiation and by genetic abnormalities that affect cell proliferation and apoptosis. These variables, when combined with clinical and staging information, can identify patients who are likely to respond to conventional therapy and those who are at high risk of refractory disease and relapse. Although the data remain incomplete there is already sufficient evidence to justify the use of molecular and cellular prognostic factors both in routine clinical practice and the design of clinical trials.