Onkologie. 2009:3(3):153-158

Current therapeutic possibilities in younger adult patients with diffuse large B-cell lymphoma

MUDr. Robert Pytlík

I. interní klinika 1. LF UK a VFN Praha

Diffuse large B-cell lymphoma (DLBCL) belongs among highly curative malignancies in younger adult patients (18–60 years). Remarkable

treatment advance during last ten years represents addition of anti-CD20 antibody rituximab (Mabthera) to standard polychemotherapeutic

treatment regimens. Further improvement of prognosis came with the introduction of dose-dense protocols (two week R-CHOP

instead of standard three week), and it seems that high treatment intensity right from the beginning is more important than late highdose

consolidation. On the other hand, significance of consolidation radiotherapy in DLBCL treatment decreases. According to Revised

International Prognostic Index (R-IPI), no group of patients has lower than 50% chance of being cured. It may be, however, that higher

efficacy of first-line therapy decreases effectivity of salvage treatment in patients with relapsed or refractory disease, though definite

proof for this conclusion is lacking so far. Radioimmunoablative therapy, high-dose chemotherapy combined with radioimmunotherapy,

or high-dose peritransplantational rituximab might improve prognosis even in these high-risk relapsed or refractory DLBCL patients.

Keywords: diffuse large B-cell lymphoma, chemotherapy, rituximab, dose-intensity.

Published: June 15, 2009  Show citation