[Highly malignant non-Hodgkin's lymphomas]

High malignant non-Hodgkin's lymphomas are rare diseases, with a rising incidence. A qualified histological classification and a thorough staging are the most important points in the further management. The treatment is primarily chemotherapeutic; radiation is only used in selected situations. The success of the very first therapy is most important for the outcome. To date no one of the modern intensive treatment regimens could show an advantage over conventional CHOP. For treatment failures autologous or allogenic bone-marrow-transplantation is the best option. Whether bone-marrow-transplantation in first remission can improve the treatment results waits to be answered. HIV-associated lymphomas are an increasing problem. For selected patients intensive chemotherapy with growth factors seems to improve the results. Conflicting are the therapy data in elderly patients. Most centers accept a higher lymphoma mortality with reduced doses. With special designed treatment regimens it is probably possible to come to an acceptable outcome even in elderly patients.