[Clinical Research Progress on Transformed Lymphoma -Review]

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Histologic transformation (HT) is a common complication in indolent lymphoma, associated with poor prognosis.
• Accurate diagnosis of HT relies on clinical signs, PET-CT scans, and crucially, pathological biopsy.
• Conflicting information exists regarding the influence of initial treatment strategies on the risk of transformation.

Purpose of the Study:

• To clarify the diagnostic standards for histologic transformation in indolent lymphoma.
• To evaluate the impact of initial management on the risk of transformation.
• To outline appropriate treatment strategies for patients with histologic transformation.

Main Methods:

• Review of clinical manifestations and diagnostic modalities including PET-CT and pathological biopsy.
• Analysis of treatment outcomes based on prior R-CHOP chemotherapy status.
• Evaluation of second-line chemotherapy regimens and consolidation options like HDT-ASCT.

Main Results:

• Pathological biopsy is the gold standard for diagnosing HT.
• Treatment recommendations differ for chemotherapy-naive patients versus those who received R-CHOP prior to HT.
• High-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) is a consideration for eligible young patients.

Conclusions:

• Initial management strategies may influence the risk of HT, though data are contradictory.
• Patients without prior R-CHOP should receive it upon diagnosis of HT.
• For patients previously treated with R-CHOP, second-line chemotherapy for diffuse large B-cell lymphoma (DLBCL) is indicated.
• Radio-immunotherapy and novel agents offer promising future therapeutic avenues for HT.