Abstract
Diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) accounting for approximately 30% of new lymphoma diagnoses in adult patients. Complete remissions (CRs) can be achieved in 45% to 55% of patients and cure in approximately 30–35% with anthracycline-containing combination chemotherapy. The ageadjusted IPI (aaIPI) has been widely employed, particularly to “tailor” more intensive therapy such as high-dose therapy (HDT) with autologous hemopoietic stem cell rescue (ASCT). IPI, however, has failed to reliably predict response to specific therapies. A subgroup of young patients with poor prognosis exists. To clarify the role of HDT/ASCT combined with rituximab in the front line therapy a longer follow-up and randomized studies are needed. The benefit of HDT/ASCT for refractory or relapsed DLBCL is restricted to patients with immunochemosensitive disease. Currently, clinical and biological research is focused to improve the curability of this setting of patients, mainly young.
Highlights
Diffuse large B-cell non-Hodgkin’s lymphoma (DLBCL) is the commonest histological subtype of non-Hodgkin’s lymphomas (NHL) accounting for approximately 30% of new lymphoma diagnoses in adult patients
The International Prognostic Index (IPI) has proved valuable for stratification of patients in clinical trials and remains the prognostic system more widely employed in clinical research and daily practice
These results suggested the possibility of improving the outcome of aggressive NHL patients by including high-dose therapy (HDT)/autologous hemopoietic stem cell rescue (ASCT) in the first-line therapy
Summary
Diffuse large B-cell non-Hodgkin’s lymphoma (DLBCL) is the commonest histological subtype of non-Hodgkin’s lymphomas (NHL) accounting for approximately 30% of new lymphoma diagnoses in adult patients. This, in part, reflects the inherent biological heterogeneity of DLBCL and highlights the need for more precise, patient-specific, and biologically based risk factors. Despite these criticisms, the IPI has proved valuable for stratification of patients in clinical trials and remains the prognostic system more widely employed in clinical research and daily practice. Clinical and biological research is focused to improve the curability of this setting of patients, mainly young
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