Diffuse large B-cell lymphoma: R-CHOP failure—what to do?

摘要: Although rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the standard treatment for patients with diffuse large B-cell lymphoma (DLBCL), ∼30% to 50% of are not cured by this treatment, depending on disease stage or prognostic index. Among whom R-CHOP therapy fails, 20% suffer from primary refractory (progress during right after treatment) whereas 30% relapse achieving complete remission (CR). Currently, there no good definition enabling us identify these 2 groups upon diagnosis. Most exhibit double-hit (MYC-BCL2 rearrangement) double-protein-expression hyperexpression) which have a more aggressive clinical picture. New strategies currently being explored obtain better CR rates fewer relapses. young relapsing treated high-dose followed autologous transplant, an unmet need salvage regimens in setting. To prevent relapse, maintenance immunomodulatory agents such as lenalidomide undergoing investigation. drugs will most likely be introduced over next few years probably different patients.