[Current diagnostic and therapeutic standards in aggressive B-cell lymphomas]

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Aggressive B-cell lymphomas require updated diagnostic and therapeutic strategies.
• The "cell of origin" classification (ABC and GCB subtypes) is now part of the WHO classification for diffuse large B-cell lymphomas (DLBCL).

Purpose of the Study:

• To review recent advancements in the diagnosis and treatment of aggressive B-cell lymphomas.
• To highlight new classifications and therapeutic standards for DLBCL.

Main Methods:

• Review of current literature on DLBCL classification and treatment guidelines.
• Analysis of data regarding first-line treatments, CNS relapse prophylaxis, and management of relapsed/refractory disease.

Main Results:

• R-CHOP remains standard for DLBCL, with potential shortening for low-risk patients.
• CNS-IPI aids in identifying high-risk patients for CNS relapse, suggesting high-dose methotrexate.
• CAR-T cell therapy offers curative potential for relapsed/refractory DLBCL, with new antibody-drug conjugates and bispecific antibodies showing promise.

Conclusions:

• The classification of DLBCL has evolved, impacting treatment decisions.
• Risk-adapted strategies and novel therapies are expanding treatment options for aggressive B-cell lymphomas.
• Future treatments may include antibody-drug conjugates and bispecific antibodies for broader therapeutic application.