Diffuse large B-cell lymphoma: a consensus practice statement from the Australasian Lymphoma Alliance

Joel Wight; Nada Hamad; Belinda A Campbell; Matthew Ku; Kenneth Lee; Hannah Rose; Tasman Armytage; Maya Latimer; Hui-Peng Lee; Sze-Ting Lee; Michael Dickinson; Richard Khor; Emma Verner

doi:10.1111/imj.15533

Diffuse large B-cell lymphoma: a consensus practice statement from the Australasian Lymphoma Alliance

Intern Med J. 2022 Sep;52(9):1609-1623. doi: 10.1111/imj.15533. Epub 2022 Jul 21.

Authors

Joel Wight^{1

2

3

4}, Nada Hamad^{5

6

7}, Belinda A Campbell^{8

9

10}, Matthew Ku¹¹, Kenneth Lee^{12

13}, Hannah Rose^{14

15}, Tasman Armytage¹⁶, Maya Latimer^{17

18}, Hui-Peng Lee¹⁹, Sze-Ting Lee², Michael Dickinson^{3

10

20}, Richard Khor², Emma Verner^{12

21}

Affiliations

¹ Department of Haematology and Bone Marrow Transplantation, Townsville University Hospital, Townsville, Queensland, Australia.
² Department of Haematology, Austin Health, Melbourne, Victoria, Australia.
³ School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
⁴ School of Medicine, James Cook University, Townsville, Queensland, Australia.
⁵ Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.
⁶ School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia.
⁷ St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
⁸ Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁹ Department of Clinical Pathology, University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
¹¹ Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia.
¹² School of Medicine, University of Sydney, Sydney, New South Wales, Australia.
¹³ Anatomical Pathology Department, NSW Health Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
¹⁴ Department of Haematology, University Hospital, Geelong, Victoria, Australia.
¹⁵ School of Medicine, Deakin University, Geelong, Victoria, Australia.
¹⁶ Department of Haematology, Gosford Hospital, Gosford, New South Wales, Australia.
¹⁷ Department of Haematology, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
¹⁸ Department of Haematology, Australian National University, Canberra, Australian Capital Territory, Australia.
¹⁹ Department of Haematology, Flinders Medical Centre, Adelaide, South Australia, Australia.
²⁰ Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
²¹ Department of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.

PMID: 34532916
DOI: 10.1111/imj.15533

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma subtype, accounting for 30-40% of lymphoma diagnoses. Although aggressive, cure is achievable in approximately 60% of cases with primary chemoimmunotherapy, and in a further substantial minority by salvage therapy and autologous stem cell transplantation. Despite promising activity in early phase clinical trials, no intensified or novel treatment regimen has improved outcomes over R-CHOP21 in randomised studies. However, there remain several areas of controversy including the most appropriate prognostic markers, central nervous system prophylaxis and the optimal treatment for patients with high-risk disease. This position statement presents an evidence-based synthesis of the literature for application in Australasian practice.

Keywords: diagnosis; diffuse large B-cell lymphoma; management; prognosis.

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Consensus
Hematopoietic Stem Cell Transplantation*
Humans
Lymphoma, Large B-Cell, Diffuse* / diagnosis
Lymphoma, Large B-Cell, Diffuse* / therapy
Rituximab / therapeutic use
Transplantation, Autologous

Substances

Rituximab