How is advance-stage diffuse large B-cell lymphoma (DLBCL) treated?

Updated: Aug 20, 2020
  • Author: Shipra Gandhi, MBBS; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The use of systemic chemotherapy to successfully eradicate disseminated diffuse large B-cell lymphoma (DLBCL) was first described in the early 1970s. [95, 96] After these original reports, the cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) regimen (given every 21 days—ie, CHOP-21) became the standard of care for aggressive lymphomas in the United States.

Multiple attempts to improve survival in DLBCL patients led investigators to evaluate more intensive regimens. In a large prospective clinical trial conducted by Fisher et al on behalf of the Southwest Oncology Group (SWOG), none of 3 intensive chemotherapy regimens demonstrated any superiority to CHOP-21, and CHOP-21 was found to be less toxic. After a follow-up of 6 years, the overall survival (OS) and progression-free survival (PFS) rates were not statistically significantly different between the chemotherapeutic regimens tested. [97]


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