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

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.