Modern approaches to the first line treatment and modern world trends of Diffuse Large B-cell lymphoma
Summary. Diffuse large B-cell lymphoma are the most common lymphoid malignancy in adults. The article provides an overview of clinical studies of the different DLBCL therapy regimens effectiveness. The authors made the analysis of studies which are base for the clinical guidelines for the treatment of this category of patients, provided current global trends and results of clinical trials that finished in 2010-2011, according to their results there were changes in existing standards. Approaches to the treatment of DLBCL are changing dynamically from the introduction of first standard regimen CHOP in 1993, to farther intensification of this regimen and introduction of such regimens as СНОР-14, СНОЕР, М-МАСОР-В etc., which are also used in treatment of some categories of DLBCL. The introduction into clinical practice the monoclonal antibody rituximab in combination with CHOP regime has significantly improved treatment outcomes, and R-CHOP-21 from 2006 is considered the gold standard therapy for young patients. R-CHOP-14 was considered as a standard therapy for elderly patients. But in 2011 according to the results of the second interim analysis of phase III randomized study LNH03-6B new recommendations regarding treatment of these patients are given. The role of high dose chemotherapy and stem cell transplantation in first-line therapy are being investigated, the benefits of this approach are not proved yet. Searching for new approaches to the therapy has been going on.
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