Current Hematologic Malignancy Reports

, Volume 6, Issue 1, pp 47–57

The Role of Transplantation in Diffuse Large B-Cell Lymphoma: The Impact of Rituximab Plus Chemotherapy in First-line and Relapsed Settings

  • Celso Arrais Rodrigues
  • Poliana Alves Patah
  • Yana A. S. Novis
  • Chitra Hosing
  • Marcos de Lima
Article

DOI: 10.1007/s11899-010-0075-5

Cite this article as:
Rodrigues, C.A., Patah, P.A., Novis, Y.A.S. et al. Curr Hematol Malig Rep (2011) 6: 47. doi:10.1007/s11899-010-0075-5

Abstract

Rituximab has improved the prognosis of patients with diffuse large B-cell lymphoma, but a high proportion of patients with advanced disease will relapse or will fail to achieve a remission with front-line treatment. Salvage chemotherapy, followed by high-dose chemotherapy or radiation therapy and autologous stem cell transplantation, remains the best treatment option for such patients, especially those who retain chemosensitivity. Allogeneic transplantation is under investigation in this setting, often as a treatment for relapse after autologous transplantation. Treatment-related mortality due to graft-versus-host disease, preparative regimen toxicity, and poor immune recovery often limits its benefits. This article reviews the role of hematopoietic stem cell transplantation in the treatment of diffuse large B-cell lymphoma, the incorporation of rituximab, and avenues of clinical investigation in this rapidly evolving field.

Keywords

Diffuse large B-cell lymphomaSalvage chemotherapyRituximabStem cell transplantationSCT

Chemotherapy Regimens

BEAC

BCNU (carmustine), etoposide, cytarabine, cyclophosphamide

BEAM

BCNU (carmustine), etoposide, cytarabine, melphalan

CBV

Cyclophosphamide, BCNU (carmustine), etoposide

CHOP

Cyclophosphamide, doxorubicin, vincristine, prednisone

DHAP

Dexamethasone, high-dose cytarabine, cisplatin

ICE

Ifosfamide, etoposide, carboplatinum

ESHAP

Etoposide, methylprednisolone, cytarabine, cisplatin

MACOP-B

Methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin

MAD

Mitoxantrone, cytarabine, dexamethasone

MegaCEOP14

Biweekly dose-escalated cyclophosphamide, epirubicin, vincristine, prednisone

MegaCHOEP

Dose-escalated cyclophosphamide, doxorubicin, vincristine, etoposide, prednisone

R

Rituximab

VIM

Ifosfamide, mitoxantrone, etoposide

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Celso Arrais Rodrigues
    • 2
  • Poliana Alves Patah
    • 2
  • Yana A. S. Novis
    • 2
  • Chitra Hosing
    • 3
  • Marcos de Lima
    • 1
  1. 1.Department of Stem Cell Transplantation and Cell TherapyMD Anderson Cancer CenterHoustonUSA
  2. 2.Centro de Oncologia, Hospital Sírio LibanêsSão PauloBrazil
  3. 3.Department of Stem Cell Transplantation and Cell TherapyMD Anderson Cancer CenterHoustonUSA