Treatment and outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma: a contemporary, nationwide, population-based study in the Netherlands
Elise R. A. Pennings, Müjde Durmaz, Otto Visser, Eduardus F. M. Posthuma, Djamila E. Issa, Martine E.D. Chamuleau, Pieternella J. Lugtenburg, Marie José Kersten, Avinash G. Dinmohamed
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a common and aggressive form of non-Hodgkin lymphoma primarily affecting adults. The introduction of rituximab―a monoclonal antibody that targets the CD20 antigen on B-cells―in the early 2000s revolutionized DLBCL treatment, substantially enhancing survival outcomes [ 1 , 2 , 3 ]. Currently, rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) constitutes the standard first-line treatment for DLBCL [ 4 ]. However, 20–40% of patients experience relapsed or refractory (R/R) disease following initial R-CHOP treatment, and subsequent chemo(immuno)therapy regimens―with or without stem cell transplantation―have limited efficacy [ 3 , 4 , 5 , 6 , 7 ]. Consequently, most R/R DLBCL patients face a dismal prognosis, although recent advances, including chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies, demonstrate promising efficacy for select patient subsets [ 4 , 7 ].