RT Book, Section
A1 Smith, Stephen D.
A1 Press, Oliver W.
A2 Kaushansky, Kenneth
A2 Lichtman, Marshall A.
A2 Prchal, Josef T.
A2 Levi, Marcel M.
A2 Press, Oliver W.
A2 Burns, Linda J.
A2 Caligiuri, Michael
SR Print(0)
ID 1121100395
T1 Diffuse Large B-Cell Lymphoma and Related Diseases
T2 Williams Hematology, 9e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071833004
LK accessmedicine.mhmedical.com/content.aspx?aid=1121100395
RD 2024/04/24
AB SUMMARYDiffuse  large  B-cell  lymphomas  (DLBCLs)  comprise  a  heterogeneous  group  of  aggressive  malignancies  of  large,  transformed  B  lymphocytes.*  DLBCL  is  the  most  common  lymphoma  in  the  world  and  accounts  for  approximately  25  to  30  percent  of  lymphoma  cases  in  the  United  States.  The  incidence  increases  with  age,  with  a  median  age  at  presentation  in  the  sixth  decade.  The  disease  typically  presents  as  a  rapidly  growing  mass  that  may  involve  either  lymph  node  or  extranodal  sites,  and  often  is  associated  with  systemic  symptoms.  Approximately  50  to  60  percent  of  patients  will  present  with  advanced  stage,  disseminated  disease.  DLBCL  is  curable  with  combination  chemotherapy.  For  localized  disease,  either  three  cycles  of  rituximab,  cyclophosphamide,  doxorubicin,  vincristine,  and  prednisone  (R-CHOP)  plus  involved-field  radiation  therapy  or  six  cycles  of  (R-CHOP)  is  recommended,  whereas  for  advanced  stage  DLBCL,  six  cycles  of  R-CHOP  is  appropriate.  A  large  phase  III  intergroup  trial  testing  whether  a  novel  infusional  regimen  consisting  of  dose-adjusted  rituximab,  etoposide,  prednisone,  vincristine,  cyclophosphamide,  and  doxorubicin  (DA-R-EPOCH)  is  superior  to  standard  R-CHOP  has  been  completed,  but  the  results  not  yet  reported  as  of  this  writing.  High-dose  chemotherapy  with  autologous  stem  cell  transplantation  may  be  curative  for  patients  with  DLBCL  that  relapses  after  treatment  with  frontline  chemotherapy.