NCCN Guidelines Insights: B-Cell Lymphomas, Version 3.2019

Abstract

Diffuse large B-cell lymphomas (DLBCLs) and follicular lymphoma (FL) are the most common subtypes of B-cell non-Hodgkin’s lymphomas in adults. Histologic transformation of FL to DLBCL (TFL) occurs in approximately 15% of patients and is generally associated with a poor clinical outcome. Phosphatidylinositol 3-kinase (PI3K) inhibitors have shown promising results in the treatment of relapsed/refractory FL. CAR T-cell therapy (axicabtagene ciloleucel and tisagenlecleucel) has emerged as a novel treatment option for relapsed/refractory DLBCL and TFL. These NCCN Guidelines Insights highlight important updates to the NCCN Guidelines for B-Cell Lymphomas regarding the treatment of TFL and relapsed/refractory FL and DLBCL.

Summed rest score in gated myocardial perfusion imaging is a good predicator for treatment-related cardiotoxicity after anthracycline chemotherapy in diffuse large B-cell lymphoma patients

“…With anthracycline chemotherapy playing a prominent role in lymphoma treatment, DLBCL patients' prognoses continue to improve because of earlier detection and newer targeted therapeutic drugs. With longer survivorship, there will be a large number of DLBCL patients who will have to face the risk of cardiovascular morbidity and mortality which caused by long-term toxicity of anthracycline chemotherapy [25][26][27][28]. Cardiotoxicity caused by anthracycline is often progressive and irreversible, which The QTc interval on the electrocardiogram (ECG) refers to the QT interval corrected according to heart rate or RR interval [32].…”

Impact of the Q.Clear reconstruction algorithm on the interpretation of PET/CT images in patients with lymphoma

“…Therapeutic decisions in lymphoma patients are mostly based on clinical guidelines, such as those of the National Comprehensive Cancer Network (NCCN), in which PET/CT examination plays a pivotal role [24][25]. There is hardly any other disease with such a strong in uence of PET/CT on clinical decisions.…”

Oncologist volume and outcomes in older adults diagnosed with diffuse large B cell lymphoma

“…Cytotoxic therapy was further classified as anthracycline-containing or anthracycline-equivalent (cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) or CHOP-like) if 1 or more claims for an anthracycline, etoposide, and/or mitoxantrone regimen occurred within 14 days of the first claim for a cytotoxic chemotherapy. 14,18 We next evaluated whether DLBCL beneficiaries experienced hospitalization after treatment initiation. Here, we identified any inpatient hospital claim in the 30 days following the initiation of cytotoxic chemotherapy.…”

“…On the one hand, older adults with DLBCL may be cured with immunochemotherapy, 11,12 and guidelines generally recommend rituximab combined with an anthracycline-containing or anthracycline-equivalent regimen regardless of age. 13,14 However, comorbidities and concerns regarding treatment toxicity can limit the administration of chemotherapy, [15][16][17][18][19] with more than one quarter of older adults with DLBCL in the United States not receiving any cytotoxic chemotherapy. 20 Whether oncologist experience with treating older lymphoma patients is associated with therapy selection and clinical outcomes in this at-risk population is unknown.…”