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Abstract
<p class="first" id="P1">Diffuse large B-cell lymphomas with aberrations in MYC, BCL2
and/or BCL6 by genetic
alterations or protein expression represent a group of high grade B-cell lymphomas
with inferior outcomes when treated with standard RCHOP chemotherapy. As a result,
intensified induction regimens have been suggested in an effort to improve outcomes.
Conclusions to date have largely been drawn from retrospective data although prospective
data is slowly starting to emerge. Chemoimmunotherapy refractoriness is problematic
and relapse rates are high. Patients with double hit lymphoma appear to have increased
risk of CNS involvement and prophylaxis is recommended. There is insufficient evidence
available to date to strongly recommend for or against consolidative stem cell transplant
in this population. Collaborative clinical trials will be needed to establish a preferred
therapeutic regimen and an appropriate standard of care in this unique group of patients
with DLBCL.
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