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Journal of Clinical Oncology, Vol 23, No 26 (September 10), 2005: pp. 6387-6393
© 2005 American Society of Clinical Oncology.
DOI: 10.1200/JCO.2005.05.015

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REVIEW ARTICLE

State-of-the-Art Therapeutics: Diffuse Large B-Cell Lymphoma

Bertrand Coiffier

From the Hospices Civils de Lyon; Université Claude Bernard, Lyon, France

Address reprint requests to B. Coiffier, MD, Hematology Department, CH Lyon-Sud, 69495 Pierre Benite, France; e-mail: bertrand.coiffier{at}chu-lyon.fr.

This article is a review of the improvement in the treatment of patients with diffuse large B-cell lymphoma made during the last 10 years. Patients with diffuse large B-cell lymphoma now have a better outcome with longer survival because of two major developments: (1) increasing the dose of active drugs with shortening the time between cycles, resulting in dose-dense and/or dose-intense regimens; and (2) combining rituximab with chemotherapy. Both strategies were associated with higher response rates, lower relapse rates, longer event-free survival, longer time to progression, and longer overall survival, particularly in patients without adverse prognostic parameters. A combination of dose-dense, dose-intense regimens plus rituximab is currently being tested for poor-risk patients with diffuse large B-cell lymphoma. However, much work has to be done for patients with high-risk lymphoma. It may come with a better definition of genetic abnormalities specifically associated with refractoriness to chemotherapy.

Author's disclosures of potential conflicts of interest are found at the end of this article.


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