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2021 Update on Diffuse large B cell lymphoma: A review of current data and potential applications on risk stratification and management

Journal

AMERICAN JOURNAL OF HEMATOLOGY
Volume 96, Issue 5, Pages 617-629

Publisher

WILEY
DOI: 10.1002/ajh.26151

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Funding

  1. Abramson Cancer Center's Ruth L. Kirschstein National Research Service Award (NRSA) Institutional T32 Research Training Grant [5T32CA009615-30]
  2. National Center for Advancing Translational Sciences of the National Institutes of Health [5T32CA009615-30, TL1TR001880]

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Diffuse large B cell lymphoma (DLBCL) is the most common type of Non-Hodgkin lymphoma (NHL) with diverse biology and clinical characteristics. R-CHOP is the mainstay treatment, providing long-term disease control in nearly 90% of limited-stage patients and up to 60% of advanced-stage patients. Understanding the genetic and molecular features has identified high-risk subsets, with ongoing studies on risk-adapted therapy, while immunotherapy, particularly adoptive T-cell therapy, has significantly improved outcomes for relapsed refractory disease patients.
Diffuse large B cell lymphoma (DLBCL), the most common type of Non-Hodgkin lymphoma (NHL), comprises a heterogeneous group of diseases with different biology, clinical presentations, and response to treatment. R-CHOP remains the mainstay of therapy and can achieve long-term disease control in nearly 90% of patients presenting with limited-stage and in up to 60% of those presenting with advanced stages. Advances on the understanding of the genetic landscape and molecular features of DLBCL have identified high-risk subsets with poor outcomes to chemo-immunotherapy that are actively being studied in clinical trials. Novel therapies could potentially improve outcomes for patients with high-risk disease. Studies evaluating risk-adapted therapy based on classification by cell of origin (COO) and molecular features are ongoing. Developments in the fields of immunotherapy, mostly with adoptive T-cell therapy, have significantly improved the outcomes of patients with relapsed refractory disease. In this review, we will summarize the recent data and discuss ongoing efforts to improve DLBCL treatment in the frontline and relapsed refractory settings.

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