Current treatment options in diffuse large B‑cell lymphoma

01/2021

MUDr. David Belada, Ph.D.

IV. interní hematologická klinika LF UK a FN, Hradec Králové

SUMMARY

Diffuse large B-cell lymphoma represents heterogenous group of diseases. Standard therapy of first line is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) leading to 60% probability of long-term remission. Approximately 40% of patients relapse or the disease is primary refractory. Prognosis of this patient is unfavourable. Standard treatment approach in younger relapsed DLBCL patients is salvage chemotherapy with autologous stem cell transplantation. Only few options are available in group of elderly patients with relapsed DLBCL, mostly combination of bendamustine and rituximab or gemcitabine-based regimens. There are several new treatment options, especially therapy with genetically modified T-lymphocytes (CAR-T), polatuzumab vedotin in combination with bendamustine and rituximab or bispecific antibodies. This targeted therapy to DLBCL subtypes will surely be a large part of how to successfully treat the relapsed DLBCL patients in future.

Key words

lymphoma, DLBCL, relapse, prognosis, targeted therapy