The management of diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most common histologic type among the lymphomas. It is an aggressive neoplasm but also constitutes a therapeutic challenge since in many cases it can be cured, due to its inherent chemosensitivity. The biology and the clinical course of DLBCL are highly heterogenous and efforts have been made to identify clinical risk factors in order to apply a stratification system. A plethora of chemotherapeutic combinations have been used to treat DLBCL, but the CHOP regimen remains the treatment of choice for the majority of patients. The addition of rituximab to CHOP (immunochemotherapy) represents a significant step forward, and this has been widely accepted as the standard combination. Many questions, however, are still unanswered, and for many patients the outcome of treatment falls short of expectations. This paper provides a comprehensive review of the prognosis of primary nodal DLBCL and its first-line treatment.