TY - CHAP M1 - Book, Section TI - Diffuse Large B-Cell Lymphoma and Related Diseases A1 - Dickinson, Michael A1 - Seymour, John F. A2 - Kaushansky, Kenneth A2 - Prchal, Josef T. A2 - Burns, Linda J. A2 - Lichtman, Marshall A. A2 - Levi, Marcel A2 - Linch, David C. PY - 2021 T2 - Williams Hematology, 10e AB - SUMMARYDiffuse large B-cell lymphoma (DLBCL) is the most common lymphoma diagnosis globally. The term DLBCL encompasses several distinct subtypes of lymphoma that differ by histologic features, molecular drivers, epidemiologic risk factors, and at times, treatment selection. The common unifying feature is the presence of aggregates of large, malignant centroblast B lymphocytes. Although DLBCL occurs at all ages, the incidence increases with age and peaks in the seventh decade of life. The typical clinical presentation is with a rapidly enlarging lymph nodes, although extranodal involvement occurs frequently. Systemic symptoms occur in a substantial subset of patients and include fever, sweats, and weight loss. The goal of treatment is cure, which is achievable in approximately two-thirds of patients with combination chemoimmunotherapy. The mainstay of therapy is cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab (R-CHOP) given every 21 days for six cycles. Early-stage disease may also be managed with fewer cycles of chemoimmunotherapy with or without radiotherapy. In patients who relapse, salvage chemotherapy at standard doses is rarely curative. High-dose chemotherapy and autologous stem cell transplantation cure a significant minority of patients who have relapsed disease. Chimeric antigen receptor T cells targeting the cluster of differentiation-19 (CD19) antigen have efficacy as a third-line or subsequent therapy and are being evaluated as an alternative to autologous stem cell transplantation in first relapse in prospective clinical trials. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1178751274 ER -