ABSTRACT
Introduction 1244 Clinical presentation 1244 Initial requirements for treatment 1245 Diagnosis and staging 1245 Prognostic factors 1245 Response evaluation and clinical endpoints 1245 Therapeutic options in diffuse large B cell lymphoma 1246 Development of dose-dense and dose-intense regimens 1246 The rituximab effect 1246 Good-risk patients 1246 Older patients with poor-risk diffuse large B cell lymphoma 1248 Young patients with intermediate-risk diffuse large 1250
B cell lymphoma Young patients with poor-risk diffuse large B cell lymphoma 1251 Very old patients with diffuse large B cell lymphoma 1251 Positron emission tomography scans for evaluation 1251
of response and making treatment decisions Special locations 1252 Gastrointestinal tract lymphomas 1252 Primary central nervous system lymphomas 1252
Skin lymphomas 1253 Diffuse large B cell lymphomas of bone 1253 Special situations 1253 Post-transplant lymphoma and lymphoproliferative disorders 1253 Lymphoma during pregnancy 1253 Patients with transformed lymphoma at time of diagnosis 1254 Nonresponding patients 1254 Refractory patients 1254 Partial response 1254 Treatment at recurrence 1254 High-dose treatment 1254 Future developments and pending questions 1255 Immunotherapy 1255 Radiation therapy 1255 Drug resistance 1255 Oncogene modulation and antioncogenes as lymphoma 1255
treatment Conclusions 1255 Key points 1256 References 1256
Diffuse large B cell lymphoma (DLBCL) is the most frequent lymphoma worldwide, accounting for 30 percent to 40 percent of all lymphomas encountered in adults.1-3 This lymphoma is described as aggressive since it has a poor outcome if inadequately treated or if primary treatment fails to induce a response. It is, however, a curable disease in a significant percentage of patients, depending on the initial characteristics of the disease.
