Treatment of Diffuse Large B-Cell Lymphoma

Overview

Journal J Clin Exp Hematop

Specialties Hematology
Pathology

Date 2016 Dec 17

PMID 27980306

Citations 37

Authors

Kana Miyazaki

Affiliations

Soon will be listed here.

Abstract

Diffuse large B-cell lymphoma (DLBCL) comprises a heterogeneous group with pathophysiological, genetic and clinical features. Many patients can be cured with R-CHOP therapy, which is the current standard regimen. Despite recent progress in improving patient survival, the 40% survival of DLBCL patients remains poor. Therefore, the most important issue for patients with DLBCL remains the development of a new front-line therapy. Several studies have reported that intensified chemotherapy with dose-adjusted EPOCH-R or R-ACVBP was superior to R-CHOP. Gene expression profiling has identified two distinct forms of DLBCL: activated B cell-like (ABC) and germinal center B-cell-like (GCB) types. ABC DLBCL exhibits a worse prognosis than GCB DLBCL by molecular diagnosis after R-CHOP therapy. Next-generation sequencing has identified unique oncogenic mechanisms and genetic complexity, which has provided rational therapeutic targets. There are also a number of biomarkers, including CD5, and prognostic factors. Efforts to distinguish many biomarkers will be crucial for individualized treatment in the future.

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References

Alizadeh A, Eisen M, Davis R, Ma C, Lossos I, Rosenwald A . Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling. Nature. 2000; 403(6769):503-11. DOI: 10.1038/35000501. View

Yamaguchi M, Seto M, Okamoto M, Ichinohasama R, Nakamura N, Yoshino T . De novo CD5+ diffuse large B-cell lymphoma: a clinicopathologic study of 109 patients. Blood. 2002; 99(3):815-21. DOI: 10.1182/blood.v99.3.815. View

Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R . CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002; 346(4):235-42. DOI: 10.1056/NEJMoa011795. View

HOLLENDER A, Kvaloy S, Nome O, Skovlund E, Lote K, Holte H . Central nervous system involvement following diagnosis of non-Hodgkin's lymphoma: a risk model. Ann Oncol. 2002; 13(7):1099-107. DOI: 10.1093/annonc/mdf175. View

Tilly H, Lepage E, Coiffier B, Blanc M, Herbrecht R, Bosly A . Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2003; 102(13):4284-9. DOI: 10.1182/blood-2003-02-0542. View

Feugier P, Virion J, Tilly H, Haioun C, Marit G, Macro M . Incidence and risk factors for central nervous system occurrence in elderly patients with diffuse large-B-cell lymphoma: influence of rituximab. Ann Oncol. 2003; 15(1):129-33. DOI: 10.1093/annonc/mdh013. View

Pfreundschuh M, Trumper L, Kloess M, Schmits R, Feller A, Rube C . Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood. 2004; 104(3):634-41. DOI: 10.1182/blood-2003-06-2095. View

Pfreundschuh M, Trumper L, Osterborg A, Pettengell R, Trneny M, Imrie K . CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006; 7(5):379-91. DOI: 10.1016/S1470-2045(06)70664-7. View

Habermann T, Weller E, Morrison V, Gascoyne R, Cassileth P, Cohn J . Rituximab-CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphoma. J Clin Oncol. 2006; 24(19):3121-7. DOI: 10.1200/JCO.2005.05.1003. View

10.

Boehme V, Zeynalova S, Kloess M, Loeffler M, Kaiser U, Pfreundschuh M . Incidence and risk factors of central nervous system recurrence in aggressive lymphoma--a survey of 1693 patients treated in protocols of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol. 2006; 18(1):149-157. DOI: 10.1093/annonc/mdl327. View

11.

Bonnet C, Fillet G, Mounier N, Ganem G, Molina T, Thieblemont C . CHOP alone compared with CHOP plus radiotherapy for localized aggressive lymphoma in elderly patients: a study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2007; 25(7):787-92. DOI: 10.1200/JCO.2006.07.0722. View

12.

Pfreundschuh M, Schubert J, Ziepert M, Schmits R, Mohren M, Lengfelder E . Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60). Lancet Oncol. 2008; 9(2):105-16. DOI: 10.1016/S1470-2045(08)70002-0. View

13.

Lenz G, Davis R, Ngo V, Lam L, George T, Wright G . Oncogenic CARD11 mutations in human diffuse large B cell lymphoma. Science. 2008; 319(5870):1676-9. DOI: 10.1126/science.1153629. View

14.

Wilson W, Dunleavy K, Pittaluga S, Hegde U, Grant N, Steinberg S . Phase II study of dose-adjusted EPOCH and rituximab in untreated diffuse large B-cell lymphoma with analysis of germinal center and post-germinal center biomarkers. J Clin Oncol. 2008; 26(16):2717-24. PMC: 2409217. DOI: 10.1200/JCO.2007.13.1391. View

15.

Persky D, Unger J, Spier C, Stea B, LeBlanc M, McCarty M . Phase II study of rituximab plus three cycles of CHOP and involved-field radiotherapy for patients with limited-stage aggressive B-cell lymphoma: Southwest Oncology Group study 0014. J Clin Oncol. 2008; 26(14):2258-63. DOI: 10.1200/JCO.2007.13.6929. View

16.

Shimada K, Matsue K, Yamamoto K, Murase T, Ichikawa N, Okamoto M . Retrospective analysis of intravascular large B-cell lymphoma treated with rituximab-containing chemotherapy as reported by the IVL study group in Japan. J Clin Oncol. 2008; 26(19):3189-95. DOI: 10.1200/JCO.2007.15.4278. View

17.

Yamaguchi M, Nakamura N, Suzuki R, Kagami Y, Okamoto M, Ichinohasama R . De novo CD5+ diffuse large B-cell lymphoma: results of a detailed clinicopathological review in 120 patients. Haematologica. 2008; 93(8):1195-202. DOI: 10.3324/haematol.12810. View

18.

Lenz G, Wright G, Dave S, Xiao W, Powell J, Zhao H . Stromal gene signatures in large-B-cell lymphomas. N Engl J Med. 2008; 359(22):2313-23. PMC: 9103713. DOI: 10.1056/NEJMoa0802885. View

19.

Bernstein S, Unger J, LeBlanc M, Friedberg J, Miller T, Fisher R . Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 -- the Southwest Oncology Group. J Clin Oncol. 2008; 27(1):114-9. PMC: 4879698. DOI: 10.1200/JCO.2008.16.8021. View

20.

Dunleavy K, Pittaluga S, Czuczman M, Dave S, Wright G, Grant N . Differential efficacy of bortezomib plus chemotherapy within molecular subtypes of diffuse large B-cell lymphoma. Blood. 2009; 113(24):6069-76. PMC: 2699229. DOI: 10.1182/blood-2009-01-199679. View