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Title: Limited-stage Diffuse Large B-cell Lymphoma.
Austin Authors: Hawkes, Eliza A ;Barraclough, Allison ;Sehn, Laurie H
Affiliation: Olivia Newton-John Cancer Research Institute
Medicine (University of Melbourne)
BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Eastern Health, Melbourne, VIC, Australia
Fiona Stanley Hospital, Perth, WA, Australia
The University of British Columbia, Vancouver, BC, Canada
Issue Date: 10-Feb-2022 2021
Publication information: Blood 2022; 139(6): 822-834
Abstract: DLBCL, the most common lymphoma subtype, is localized in 25-30% of patients. Prognosis in patients with limited-stage DLBCL (LS-DLBCL) is excellent with 10-year overall survival of at least 70-80%. Improved insights into the disease biology, the availability of positron-emission tomography (PET) scans and recent dedicated clinical trials within this unique population, have led to evolving treatment paradigms. However, no standard definition of LS-DLBCL exists, and while generally defined as Ann Arbor stages I-II disease with largest mass size <10cm in diameter, variations across studies cause challenges in interpretation. Similar to advanced-stage disease, R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) immunochemotherapy forms the basis of treatment, with combined modality therapy including 3 cycles of systemic treatment and involved-site radiation therapy being a predominant historical standard. Yet the well-described continuous risk of relapse beyond 5 years and established late complications of radiotherapy have challenged previous strategies. More rigorous baseline staging and response assessment with PET may improve decision making. Recent clinical studies have focused on minimizing toxicities while maximizing disease outcomes using strategies such as abbreviated immunochemotherapy alone and PET-adapted radiotherapy delivery. This comprehensive review provides an update of recent literature with recommendations for integration into clinical practice for LS-DLBCL patients.
DOI: 10.1182/blood.2021013998
ORCID: 0000-0002-0376-2559
Journal: Blood
PubMed URL: 34932795
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

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