Frontline Treatment of Aggressive B-cell Lymphoma
DOI:
https://doi.org/10.58931/cht.2023.2341Abstract
Aggressive B-cell non-Hodgkin lymphoma, which most often manifests as diffuse large B-cell lymphoma (DLBCL), is the most common non-Hodgkin lymphoma, accounting for up to 30% of diagnosed cases. It is responsible for considerable morbidity and mortality worldwide, with a global burden of approximately 150,000 new patients annually. Large B-cell lymphoma encompasses a group of lymphomas with significant clinical and biological heterogeneity. While there are approximately 18 variations of large B-cell lymphoma in the upcoming 5th edition of the World Health Organization classification of lymphoid neoplasms (WHO-HAEM5), for the purposes of this review the aggressive B-cell lymphomas will refer to the most common entity, diffuse large B-cell lymphoma, not otherwise specified (DLBCL), as well as diffuse large B-cell lymphoma/high-grade B-cell lymphoma with MYC and BCL2 rearrangements (DLBCL/HGBL-MYC/BCL2), and high-grade B-cell lymphoma, not otherwise specified (HGBL,NOS).
References
Sehn LH, Salles G. Diffuse large b-cell lymphoma. N Engl J Med. 2021;384(9):842-858.
Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia. 2022;36(7):1720–1748.
Barraclough A, Hawkes E, Sehn LH, et al. Diffuse large B-cell lymphoma. Haematol Oncol. 2023;
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(25):1937-1947.
Scott DW, Mottok A, Ennishi D, et al. Prognostic significance of diffuse large b-cell lymphoma cell of origin determined by digital gene expression in formalin-fixed paraffin-embedded tissue biopsies. J Clin Oncol. 2015;33(26):2848-2856.
Alduaij W, Collinge B, Ben-Neriah S, et al. Molecular determinants of clinical outcomes in a real-world diffuse large B-cell lymphoma population. Blood. 2023;141(20):2493-2507.
Vitolo U, Trněný M, Belada D, , et al. Obinutuzumab or rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in previously untreated diffuse large b-cell lymphoma. J Clin Oncol. 2017;35(31):3529-3537.
Delarue R, Tilly H, Mounier N, et al. Dose-dense rituximab-CHOP compared with standard rituximab-CHOP in elderly patients with diffuse large B-cell lymphoma (the LNH03-6B study): a randomised phase 3 trial. Lancet Oncology. 2013;14(6):525-533.
Bartlett NL, Wilson WH, Jung SH, et al. Dose-adjusted EPOCH-R compared with R-CHOP as frontline therapy for diffuse large b-cell lymphoma: clinical outcomes of the Phase III Intergroup Trial Alliance/CALGB 50303. J Clin Oncol. 2019;37(21):1790-1799.
Davies A, Cummin TE, Barrans S, et al. Gene-expression profiling of bortezomib added to standard chemoimmunotherapy for diffuse large B-cell lymphoma (REMoDL-B): an open-label, randomised, phase 3 trial. Lancet Oncology. 2019;20(5):649-662.
Davies AJ, Stanton L, Caddy J, et al. Five-year survival results from the remodl-B trial (ISRCTN 51837425) show improved outcomes in diffuse large B-cell lymphoma molecular subgroups from the addition of bortezomib to R-CHOP chemoimmunotherapy. Blood. 2022;140(Suppl 1):1770-1772. Abstract 735.
Younes A, Sehn LH, Johnson P, et al. Randomized phase III trial of ibrutinib and rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in non-germinal center b-cell diffuse large b-cell lymphoma. J Clin Oncol. 2019;37(15):1285-1295.
Nowakowski GS, Hong F, Scott DW, et al. Addition of lenalidomide to R-CHOP improves outcomes in newly diagnosed diffuse large b-cell lymphoma in a randomized phase II US Intergroup Study ECOG-ACRIN E1412. J Clin Oncol. 2021;39(12):1329–38.
Nowakowski GS, Chiappella A, Gascoyne RD, et al, et al. ROBUST: a phase III study of lenalidomide plus R-CHOP versus placebo plus R-CHOP in previously untreated patients with ABC-type diffuse large b-cell lymphoma. J Clin Oncol. 2021;39(12):1317-1328.
Tilly H, Morschhauser F, Sehn LH, et al. Polatuzumab vedotin in previously untreated diffuse large b-cell lymphoma. N Engl J Med. 2022;386(4):351-363.
Olszewski AJ, Kurt H, Evens AM. Defining and treating high-grade B-cell lymphoma, NOS. Blood. 2022;140(9):943–54.
Savage KJ, Johnson NA, Ben-Neriah S, et al. MYC gene rearrangements are associated with a poor prognosis in diffuse large B-cell lymphoma patients treated with R-CHOP chemotherapy. Blood. 2009;114(17):3533-3537.
Laude MC, Lebras L, Sesques P, et al. First-line treatment of double-hit and triple-hit lymphomas: Survival and tolerance data from a retrospective multicenter French study. Am J Hematol. 2021;96(3):302–11.
Chen Y, Cai Q, Chang Yet al. High-intensity chemotherapy improved the prognosis of patients with high-grade B-cell lymphoma. Front Immunol. 2022 Dec 23;13:1047115.
Moharana L, Dasappa L, Babu S, et al. Comparison between CHOP and DAEPOCH with or without rituximab in adult high grade b cell lymphoma, not otherwise specified; a retrospective study from a tertiary cancer hospital in South India. Indian J Front Hematol Blood Transfus. 2022 Jan;38(1):15-23.
Strüßmann T, Glatzki F, Engelhardt M, et al. Favourable outcomes of double-hit/double-expressor lymphoma and high-grade B-cell lymphoma, not otherwise specified after early dose-intensive treatment and up-front autologous stem cell transplantation: a single-centre retrospective experience. Br J Hematol. 2022 Aug;198(4):776-779.
Zeremski V, McPhail ED, Habermann TM, et al. Treatment intensification might not improve survival in high-grade B-cell lymphoma with a concurrent MYC and BCL2 and/or BCL6 rearrangement: A retrospective, multicenter, pooled analysis. Hematol Oncol. 2023 March 21. doi: 10.1002/hon.3130. Online ahead of print.
Zeremski V, Kropf S, Koehler M, et al. Induction treatment in high-grade B-cell lymphoma with a concurrent MYC and BCL2 and/or BCL6 rearrangement: a systematic review and meta-analysis. Front Oncol. 2023 Jul 20;13:1188478.
Mead GM, Barrans SL, Qian W, et al. UK National Cancer Research Institute Lymphoma Clinical Studies Group; Australasian Leukaemia and Lymphoma Group. A prospective clinicopathologic study of dose-modified CODOX-M/IVAC in patients with sporadic Burkitt lymphoma defined using cytogenetic and immunophenotypic criteria (MRC/NCRI LY10 trial). Blood. 2008 Sep 15;112(6):2248-2260.
McMillan AK, Phillips EH, Kirkwood AA, et al. Favourable outcomes for high-risk diffuse large B-cell lymphoma (IPI 3-5) treated with front-line R-CODOX-M/R-IVAC chemotherapy: results of a phase 2 UK NCRI trial. Ann Oncol. 2020 Sep;31(9):1251-1259.
Dunleavy K, Fanale MA, Abramson JS, et al. Dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) in untreated aggressive diffuse large B-cell lymphoma with MYC rearrangement: a prospective, multicentre, single-arm phase 2 study. Lancet Haematol. 2018;5(12):e609–e617.
Chen AI, Leonard JT, Okada CY, et al. Outcomes of DA-EPOCH-R induction plus autologous transplant consolidation for double hit lymphoma. Leuk Lymphoma. 2018 Aug;59(8):1884-1889.
Dodero A, Guidetti A, Marino F, et al. Dose-adjusted EPOCH and rituximab for the treatment of double expressor and double-hit diffuse large B-cell lymphoma: impact of TP53 mutations on clinical outcome. Haematologica. 2022;107(5):1153-1162.
Goyal G, Magnusson T, Wang X, et al. Modern, real-world patterns of care and clinical outcomes among patients with newly diagnosed diffuse large B-cell lymphoma with or without double/triple-hit status in the United States. Haematologica. 2023;108(4):1190-1195.

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