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SEOM-GOTEL clinical guidelines on diffuse large B-cell lymphoma (update 2025).

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Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
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Summary

Diffuse large B-cell lymphoma (DLBCL) management is evolving. While R-CHOP remains standard, new therapies for relapsed DLBCL show promise and may challenge current first-line treatments.

Keywords:
DiagnosisDiffuse large B-cell lymphomaGuidelineTreatment

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Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma.
  • Diagnosis requires lymph node biopsy and expert hematopathology review.
  • R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) has been the standard first-line treatment for two decades.

Purpose of the Study:

  • To summarize current evidence and therapies for DLBCL management.
  • To provide updated guidelines for 2025.
  • To discuss the evolving landscape of DLBCL treatment.

Main Methods:

  • Review of current evidence and available therapies for DLBCL.
  • Analysis of treatment outcomes for first-line and relapsed disease.
  • Synthesis of information for updated clinical guidelines.

Main Results:

  • R-CHOP remains the standard first-line treatment, with no significant improvements from modifications.
  • Therapies for relapsed or progressive DLBCL are rapidly advancing.
  • New treatments like CAR T-cells and bispecific antibodies are emerging.

Conclusions:

  • Novel therapies are transforming outcomes for relapsed DLBCL.
  • These advancements may soon challenge R-CHOP's role in newly diagnosed DLBCL.
  • Updated guidelines will reflect these significant treatment shifts.