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

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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.

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Abbreviations

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

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Authors and Affiliations

  1. Department of Stem Cell Transplantation and Cell Therapy, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 423, Houston, TX, 77035, USA

    Marcos de Lima

  2. Centro de Oncologia, Hospital Sírio Libanês, São Paulo, Brazil

    Celso Arrais Rodrigues, Poliana Alves Patah & Yana A. S. Novis

  3. Department of Stem Cell Transplantation and Cell Therapy, MD Anderson Cancer Center, Houston, TX, USA

    Chitra Hosing

Authors
  1. Celso Arrais Rodrigues
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  2. Poliana Alves Patah
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  3. Yana A. S. Novis
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  4. Chitra Hosing
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  5. Marcos de Lima
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Correspondence to Marcos de Lima.

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Rodrigues, C.A., Patah, P.A., Novis, Y.A.S. et al. The Role of Transplantation in Diffuse Large B-Cell Lymphoma: The Impact of Rituximab Plus Chemotherapy in First-line and Relapsed Settings. Curr Hematol Malig Rep 6, 47–57 (2011). https://doi.org/10.1007/s11899-010-0075-5

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