Treatment of patients with diffuse large B-cell lymphoma

Abstract

In the last 10 years, options for treating patients with diffuse large B-cell lymphoma (DLBCL) have greatly expanded. In randomized clinical studies, the addition of rituximab to cyclophosphamide, vincristine, doxorubicin, prednisone (CHOP) delivered every 3 weeks (R-CHOP) has been associated with improved survival rates, without increased toxicity, in all patient groups studied. Another strategy, giving patients dose-dense CHOP - CHOP every 2 weeks or CHOP-14 - has also been found appropriate for all patients between the ages of 18 and 75 years but probably not superior to R-CHOP-21. Strategies with dose-intense regimens are currently tested for improving the outcome of young patients with poor risk DLBCL. In elderly patients, improvement in outcomes might be caused by the addition of another drug to the R-CHOP regimen. Elderly patients are best treated with R-CHOP if they do not have severe concomitant diseases.