Skip to main content
SpringerLink
Log in

Treatment of B-cell lymphomas

  • Chapter
  • First Online:
Handbook of Lymphoma

  • 1015 Accesses

Abstract

The standard treatment for patients with diffuse large B-cell lymphoma (DLBCL) is based on clinical stage. Clinical and biologic prognostic factors are used to select or stratify patients enrolled on clinical trials and are not currently used to guide the selection of standard therapy. In general, the most widely used regimen is a combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP), but other regimens are also used (Table 6.1). Patients with stage I or II disease can be treated with three cycles of RCHOP plus involved field radiation therapy or six to eight cycles of the RCHOP regimen without radiation therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Pfreundschuh M, Trumper L, Osterborg A, et al. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006;7:379-391.

    Google Scholar 

  2. Ziepert M, Hasenclever D, Kuhnt E, Glass B, Schmitz N, Pfreundschuh M, Loeffler M. Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era. J Clin Oncol. 2010;28:2373-2380.

    Google Scholar 

  3. Rosenwald A, Wright G, Chan WC, et al. The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma. N Engl J Med. 2002;346:1937-1947.

    Google Scholar 

  4. Spaepen K, Stroobants S, Dupont P, et al. Early restaging positron emission tomography with (18)F-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin’s lymphoma. Ann Oncol. 200;13:1356-1363.

    Google Scholar 

  5. Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, Lister TA. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32:3059-3068.

    Google Scholar 

  6. Ferreri AJ, Bruno-Ventre M, Donadoni G, et al. Risk-tailored CNS prophylaxis in a monoinstitutional series of 200 patients with diffuse large B-cell lymphoma treated in the rituximab era. Br J Haematol. 2015;168:654-662.

    Google Scholar 

  7. Ferreri AJ, Reni M, Foppoli M, et al. High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet. 2009;374:1512-1520.

    Google Scholar 

  8. Vitolo U, Chiappella A, Ferreri AJ, et al. First-line treatment for primary testicular diffuse large B-cell lymphoma with rituximab-CHOP, CNS prophylaxis, and contralateral testis irradiation: final results of an international phase II trial. J Clin Oncol. 2011;29:2766-2772.

    Google Scholar 

  9. Savage KJ, Monti S, Kutok JL, et al. The molecular signature of mediastinal large B-cell lymphoma differs from that of other diffuse large B-cell lymphomas and shares features with classical Hodgkin lymphoma. Blood. 2003;102:3871-3879.

    Google Scholar 

  10. Zinzani PL, Martelli M, Bertini M, et al. Induction chemotherapy strategies for primary mediastinal large B-cell lymphoma with sclerosis: a retrospective multinational study on 426 previously untreated patients. Haematologica. 2002;87:1258-1264.

    Google Scholar 

  11. Dunleavy K, Pittaluga S, Maeda LS, et al. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N Engl J Med. 2013;368:1408-1416.

    Google Scholar 

  12. Aukema SM, Siebert R, Schuuring E, et al. Double-hit B-cell lymphomas. Blood. 2011;117:2319-2331.

    Google Scholar 

  13. Petrich AM, Gandhi M, Jovanovic B, et al. Impact of induction regimen and stem celltransplantation on outcomes in double-hit lymphoma: a multicenter retrospective analysis. Blood. 2014;124:2354-2361.

    Google Scholar 

  14. Peyrade F, Jardin F, Thieblemont C, et al. Attenuated immunochemotherapy regimen (R-miniCHOP) in elderly patients older than 80 years with diffuse large B-cell lymphoma: a multicentre, single-arm, phase 2 trial. Lancet Oncol. 2011;12:460-468.

    Google Scholar 

  15. Gisselbrecht C, Glass B, Mounier N, et al. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J Clin Oncol. 2010;28:4184-4190.

    Google Scholar 

  16. Hoskin PJ, Kirkwood AA, Popova B, et al. 4 Gy versus 24 Gy radiotherapy for patients with indolent lymphoma (FORT): a randomised phase 3 non-inferiority trial. Lancet Oncol. 2014;15:457-463.

    Google Scholar 

  17. Solal-Celigny P, Bellei M, Marcheselli L, et al. Watchful waiting in low-tumor burden follicular lymphoma in the rituximab era: results of an F2-study database. J Clin Oncol. 2012;30:3848-3853.

    Google Scholar 

  18. Friedberg JW, Byrtek M, Link BK, et al. Effectiveness of first-line management strategies for stage I follicular lymphoma: analysis of the National LymphoCare Study. J Clin Oncol. 2012;30:3368-75.

    Google Scholar 

  19. Feuerlein K, Zucca E, Ghielmini M. First-line treatment of follicular lymphoma: a patientoriented algorithm. Leuk Lymphoma. 2009;50:325-334.

    Google Scholar 

  20. Rummel M, Niederle N, Maschmeyer G, et al. Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphoma: an openlabel, multicentre, randomised, phase 3 non-inferiority trial. Lancet. 2013;381:1203-1210.

    Google Scholar 

  21. Seymour JF, Feugier P, Offner F, et al. Updated 6 year follow-up of the PRIMA study confirms the benefit of 2-year rituximab maintenance in follicular lymphomapatients responding to frontline immunochemotherapy. Blood. 2013;122:abstr 509.

    Google Scholar 

  22. Sebban C, Brice P, Delarue R, et al. Impact of rituximab and/or high-dose therapy with autotransplant at time of relapse in patients with follicular lymphoma: a GELA study. J Clin Oncol. 2008;26:3614-3620.

    Google Scholar 

  23. Dreyling M; European Mantle Cell Lymphoma Network. Mantle cell lymphoma: biology, clinical presentation, and therapeutic approaches. Am Soc Clin Oncol Educ Book. 2014;34:191-198.

    Google Scholar 

  24. Hermine O, Hoster E, Walewski J, et al. Alternating courses of 3x CHOP and 3x DHAP plus rituximab followed by a high dose ARA-C containing myeloablative regimen and autologous stem cell transplantation (ASCT) increases overall survival when compared to 6 courses of CHOP plus rituximab followed by myeloablative radiochemotherapy and ASCT in mantle cell lymphoma: final analysis of the MCL Younger Trial of the European Mantle Cell Lymphoma Network (MCL net). Blood (ASH Annual Meeting Abstracts). 2012;120:151.

    Google Scholar 

  25. Hallek M, Fischer K, Fingerle-Rowson G et al. Addition of rituximab to fludarabine and cyclophosphamide in patients with chronic lymphocytic leukaemia: a randomised, openlabel, phase 3 trial. Lancet. 2010;376:1164-1174.

    Google Scholar 

  26. Fischer K, Cramer P, Busch R, et al. Bendamustine combined with rituximab in patients with relapsed and/or refractory chronic lymphocytic leukemia: a multicentre phase II trial of the German CLL Study Group. J Clin Oncol. 2011;10:3559-566.

    Google Scholar 

  27. Wierda WG, Padmanabhan S, Chan GW, et al. Hx-CD20–406 Study Investigators. Ofatumumab is active in patients with fludarabine-refractory CLL irrespective of prior rituximab: results from the phase 2 international study. Blood. 2011;118:5126-5129.

    Google Scholar 

  28. Dreger P, Corradini P, Kimby E, et al. Indications for allogeneic stem cell transplantation in chronic lymphocytic leukemia: the EBMT transplant consensus. Leukemia. 2007;21:12-17.

    Google Scholar 

  29. Furman RR, Sharman JP, Coutre SE, et al. Idelalisib and rituximab in relapsed chronic lymphocytic leukemia. N Engl J Med. 2014;370:997-1007.

    Google Scholar 

  30. Byrd JC, Furman RR, Coutre SE, et al. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med. 2013;369:32-42.

    Google Scholar 

  31. Hillmen P, Skotnicki AB, Robak T, et al. Alemtuzumab compared with chlorambucil as first-line therapy for chronic lymphocytic leukemia. J Clin Oncol. 2007;25:5616-5623.

    Google Scholar 

  32. Dreyling M, Thieblemont C, Gallamini A, et al. ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma. Ann Oncol. 2013;24:857-877.

    Google Scholar 

  33. Jacobson C, LaCasce A. How I treat Burkitt lymphoma in adults. Blood. 2014;124:2913-2920.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland

    Anastasios Stathis

  2. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ahmet Dogan

Authors
  1. Anastasios Stathis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmet Dogan
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Memorial Sloan Kettering Cancer Center, New York, New York, USA

    Anas Younes

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Stathis, A., Dogan, A. (2016). Treatment of B-cell lymphomas. In: Younes, A. (eds) Handbook of Lymphoma. Adis, Cham. https://doi.org/10.1007/978-3-319-08467-1_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-08467-1_6

  • Published:

  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-08466-4

  • Online ISBN: 978-3-319-08467-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation