What are the ESMO guidelines on the treatment of diffuse large B-cell lymphoma (DLBCL)?

Updated: Feb 25, 2021
  • Author: Sanjay Vinjamaram, MD, MPH; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

European Society for Medical Oncology recommendations

The ESMO guidelines contain specific recommendations for patients < 60 years old based on aaIPI risk. [79]

For aa-IPI=0 without bulky disease, treatment recommendations are as follows:

  • R-CHOP every 21 d for six cycles is preferred

  • Radiation therapy has no proven benefit

For aa-IPI=0 with bulky disease or aa-IPI=1, treatment recommendations are as follows:

  • R-CHOP every 21 d for six cycles with IFRT, or

  • R-ACVBP (rituximab, doxorubicin, vindesine, cyclophosphamide, bleomycin, prednisolone) and sequential consolidation

For aa-IPI≥2, ESMO notes that no standard of care has been established; enrollment in a clinical trial is preferred. R-CHOP every 21 days for eight cycles is one possible regimen.


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