Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, with limited-stage defined as stage I or II disease, having around 25-30% of newly diagnosed DLBCL this presentation. Risk stratification, initial treatment options, and relapse patterns are distinct from advanced-stage d...

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Autor principal: Mahuad , Carolina
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional de Rosario 2023
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Acceso en línea:https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/102
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spelling I15-R235-article-1022023-11-21T20:30:38Z Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas Interrogantes y evidencia sobre los nuevos estándares terapéuticos del Linfoma difuso a grandes células B en estadio localizado Mahuad , Carolina linfoma difuso a grandes células B linfomas B estadio localizado tratamiento tratamiento adaptado a PET-TC radioterapia diffuse large B-cell lymphoma limited stage B-cell lymphoma treatment PET-TC-adapted treatment radiotherapy Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, with limited-stage defined as stage I or II disease, having around 25-30% of newly diagnosed DLBCL this presentation. Risk stratification, initial treatment options, and relapse patterns are distinct from advanced-stage disease, but there is limited data on the impact of biologic features on outcome. Patients presenting with localized disease have excellent outcomes with an estimated survival at two years around 90%. Over the past years several studies have attempted to evaluate the optimal number of chemotherapy cycles, the role of radiotherapy and PET- adapted approaches in order to maximize success of therapy and minimize toxicity. Special consideration must still be given to cases of bulky disease, extranodal disease, fully resected scenarios and adverse biologic features such as high-grade B-cell lymphoma with double/triple hit rearrangements. In this review the new therapeutic options based on the best available medical evidence, as well as the remaining open questions will be discussed. El linfoma difuso a grandes células B (LDCGB) es el linfoma no Hodgkin más frecuente, siendo el estadio localizado definido como la enfermedad en estadio I o II. Alrededor del 25-30% de los casos con reciente diagnóstico se presentan en este estadio. La estratificación de riesgo, las opciones de tratamiento inicial y los patrones de recaída son distintos a las enfermedades diagnosticadas en estadios avanzados, sin embargo, no hay datos sobre el impacto de las características biológicas en el desenlace de la enfermedad localizada. Los pacientes con enfermedad localizada, tienen un excelente pronóstico con una supervivencia estimada a dos años que supera el 90%. En los últimos años, varios estudios han intentado evaluar el número óptimo de ciclos de quimioterapia requeridos para el control de la enfermedad, el rol de la radioterapia y las estrategias terapéuticas adaptadas a PET-TC a fin de maximizar el éxito terapéutico y minimizar la toxicidad. Sin embargo, debe prestarse especial atención a los casos de enfermedad voluminosa, enfermedad extra ganglionar, pacientes con enfermedad resecada en forma completa y con características biológicas adversas, tales como los linfomas de alto grado con rearreglos doble o triple hit. En esta revisión se discutirán las nuevas opciones terapéuticas basadas en la mejor evidencia médica disponible, así como los interrogantes que aún permanecen abiertos Universidad Nacional de Rosario 2023-11-08 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/102 10.35305/fcm.v3i.102 Revista de la Facultad de Ciencias Médicas. Universidad Nacional de Rosario.; Vol. 3 (2023); 8-20 2796-7719 spa https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/102/88 https://creativecommons.org/licenses/by-nc/4.0
institution Universidad Nacional de Rosario
institution_str I-15
repository_str R-235
container_title_str FCM Científica
language Español
format Artículo revista
topic linfoma difuso a grandes células B
linfomas B estadio localizado
tratamiento
tratamiento adaptado a PET-TC
radioterapia
diffuse large B-cell lymphoma
limited stage B-cell lymphoma
treatment
PET-TC-adapted treatment
radiotherapy
spellingShingle linfoma difuso a grandes células B
linfomas B estadio localizado
tratamiento
tratamiento adaptado a PET-TC
radioterapia
diffuse large B-cell lymphoma
limited stage B-cell lymphoma
treatment
PET-TC-adapted treatment
radiotherapy
Mahuad , Carolina
Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas
topic_facet linfoma difuso a grandes células B
linfomas B estadio localizado
tratamiento
tratamiento adaptado a PET-TC
radioterapia
diffuse large B-cell lymphoma
limited stage B-cell lymphoma
treatment
PET-TC-adapted treatment
radiotherapy
author Mahuad , Carolina
author_facet Mahuad , Carolina
author_sort Mahuad , Carolina
title Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas
title_short Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas
title_full Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas
title_fullStr Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas
title_full_unstemmed Open questions and evidence on new therapeutic standards for limited-stage diffuse large B-cell lymphomas
title_sort open questions and evidence on new therapeutic standards for limited-stage diffuse large b-cell lymphomas
description Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, with limited-stage defined as stage I or II disease, having around 25-30% of newly diagnosed DLBCL this presentation. Risk stratification, initial treatment options, and relapse patterns are distinct from advanced-stage disease, but there is limited data on the impact of biologic features on outcome. Patients presenting with localized disease have excellent outcomes with an estimated survival at two years around 90%. Over the past years several studies have attempted to evaluate the optimal number of chemotherapy cycles, the role of radiotherapy and PET- adapted approaches in order to maximize success of therapy and minimize toxicity. Special consideration must still be given to cases of bulky disease, extranodal disease, fully resected scenarios and adverse biologic features such as high-grade B-cell lymphoma with double/triple hit rearrangements. In this review the new therapeutic options based on the best available medical evidence, as well as the remaining open questions will be discussed.
publisher Universidad Nacional de Rosario
publishDate 2023
url https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/102
work_keys_str_mv AT mahuadcarolina openquestionsandevidenceonnewtherapeuticstandardsforlimitedstagediffuselargebcelllymphomas
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first_indexed 2024-08-12T21:45:26Z
last_indexed 2024-08-12T21:45:26Z
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