How is advance-stage diffuse large cell lymphoma treated?

Updated: Jun 12, 2019
  • 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. [91, 92] 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. Fisher et al on behalf of the Southwest Oncology Group (SWOG) reported the results of a large clinical trial conducted in the United States. [93] The study compared CHOP-21 chemotherapy with 3 intense chemotherapy regimens. The study failed to demonstrate any superiority with the intense regimens tested, and CHOP-21 was found to be equivalent but 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.


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