Large BCell Lymphoma Current Standards of 弥漫性大B细胞淋巴瘤的现行标准ppt课件.ppt

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Large BCell Lymphoma Current Standards of 弥漫性大B细胞淋巴瘤的现行标准ppt课件.ppt

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Large BCell Lymphoma Current Standards of 弥漫性大B细胞淋巴瘤的现行标准ppt课件

* DLBCL, diffuse large B-cell lymphoma; GCB, germinal-center B cell; IPI, International Prognostic Index; LDH, lactate dehydrogenase. ? From the Hans data stratifying patients into GCB vs non-GCB subtype groups and by IPI risk group, there were no clear differences within the high-risk group in terms of percentage of individuals who fell into the GCB vs non-GCB subtype. Our patient falls into the IPI high-risk group, and therefore, by clinical factors alone, we cannot clearly identify whether this patient would have a particular immunohistochemical stratified diffuse large B-cell lymphoma or a particular gene expression profile. Hans et al. Blood. 2004. Turning to current treatment approaches for initial therapy for diffuse large B-cell lymphoma, the National?Comprehensive?Cancer?Network has assembled a strategy reported in their guidelines. * * DLBCL, diffuse large B-cell lymphoma; R-CHOP, rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone. ? For patients with localized stage?I/II disease, initial therapy usually constitutes an abbreviated course of chemotherapy with immunotherapy followed by radiation or a full course of chemotherapy. For patients with advanced-stage disease, chemoimmunotherapy with a combination of rituximab and CHOP chemotherapy for 6-8 cycles is currently routinely practiced. * CHOP, cyclophosphamide, doxorubicin, vincristine, prednisone; DLBCL, diffuse large B-cell lymphoma; IFRT, involved-field radiation therapy; NHL, non-Hodgkin’s lymphoma; GI, gastrointestinal; OS, overall survival; PFS, progression-free survival. ? For patients with localized disease, SWOG?8736, presented by?Miller and colleagues and published in the New?England?Journal of Medicine in 1998, randomized patients to CHOP chemotherapy for a full course of 8 cycles vs an abbreviated course of CHOP chemotherapy for 6 cycles followed by involved-field radiation therapy. Coiffier et al. N Engl J Med. 2002;346:235 Feugier et al. J Clin Oncol. 2005;23:4117.