diffuse large B-cell lymphoma (DLBCL)

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Introduction

Appears to include more than one disease entity. Defined as a diffuse proliferation of neoplastic B cells with nuclear size greater than or equal normal macrophage nuclei or twice normal lymphocyte size.

Classification

Epidemiology

Pathology

(microscopic variants)

Immunophenotype

Genetics

Gene expression profiling differences [ref. 2]:

Clinical manifestations

Laboratory

Radiology

Management

More general terms

More specific terms

References

  1. WHO Classification Tumours of Haematopoietic and Lymphoid Tissues. IARC Press 2001.
  2. Davis RE & Staudt LM. Molecular diagnosis of lymphoid malignancies by gene expression profiling. Curr Opin Hematol 9:333-338, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12042708
  3. Alizadeh AA et al. Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling. Nature 403:503-11, 2000 PMID: https://www.ncbi.nlm.nih.gov/pubmed/10676951
  4. Compagno M et al Mutations of multiple genes cause deregulation of NF-B in diffuse large B-cell lymphoma. Nature 2009 May 3; [e-pub ahead of print] <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19412164 <Internet> http://dx.doi.org/10.1038/nature07968
  5. 5.0 5.1 Peyrade F 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 May; 12:460 http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70069-9/fulltext
  6. 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2021.
  7. Lenz G, Wright G, Dave SS et al Stromal gene signatures in large-B-cell lymphomas. N Engl J Med. 2008 Nov 27;359(22):2313-23 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19038878
  8. 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 Jun 20;346(25):1937-47. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12075054
  9. 9.0 9.1 Ferreri AJ, Govi S, Ponzoni M. The role of Helicobacter pylori eradication in the treatment of diffuse large B-cell and marginal zone lymphomas of the stomach. Curr Opin Oncol. 2013 Sep;25(5):470-9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23942292
  10. 10.0 10.1 Kostakoglu L, Goldsmith SJ, Leonard JP et al FDG-PET after 1 cycle of therapy predicts outcome in diffuse large cell lymphoma and classic Hodgkin disease. Cancer. 2006 Dec 1;107(11):2678-87 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17063502
  11. Martelli M, Ferreri AJ, Agostinelli C et al Diffuse large B-cell lymphoma. Crit Rev Oncol Hematol. 2013 Aug;87(2):146-71 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23375551
  12. 12.0 12.1 Sehn LH, Berry B, Chhanabhai M et al The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007 Mar 1;109(5):1857-61. Epub 2006 Nov 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17105812
  13. 13.0 13.1 13.2 Rush RP, Saltman AP, Prica AA, Breiner A, Detsky AS. Connecting the Dots. N Engl J Med. 2017 Sep 7;377(10):978-984. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28877025 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcps1613804
  14. Minerd J. with Expert Critique by Taylor J More-Intensive Induction Therapy for Double-Hit Lymphoma? In the absence of clinical trials, retrospective studies suggest yes. MedPage Today. ASCO Reading Room 03.21.2018 https://www.medpagetoday.com/reading-room/asco/hematologic-malignancies/71894
  15. 15.0 15.1 Schmitz R, Wright GW, Huang DW et al Genetics and Pathogenesis of Diffuse Large B-Cell Lymphoma. N Engl J Med 2018; 378:1396-1407. April 12, 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29641966 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1801445
  16. 16.0 16.1 16.2 ARUP Consult: IRF4/DUSP22 Gene Rearrangement by FISH https://arupconsult.com/ati/irf4-dusp22-rearrangements
  17. Sehn LH, Salle G Diffuse Large B-Cell Lymphoma. N Engl J Med 2021; 384:842-858 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33657296 https://www.nejm.org/doi/full/10.1056/NEJMra2027612
  18. 18.0 18.1 Bassett M Glofitamab Regimen Improves Survival in DLBCL. Granted accelerated approval last year, bispecific antibody passes its confirmatory test. MedPage Today June 20, 2024 https://www.medpagetoday.com/meetingcoverage/eha/110740

Patient information

diffuse large B-cell lymphoma patient information