Doval Dinesh Chandra, Bhurani Dinesh, Nair Reena, Gujral Sumeet, Malhotra Pankaj, Ramanan Ganpati, Mohan Ravi, Biswas Ghanshyam, Dattatreya Satya, Agarwal Shyam, Pendharkar Dinesh, Julka Pramod Kumar, Advani Suresh H, Dhaliwal Rupinder Singh, Tayal Juhi, Sinha Rupal, Kaur Tanvir, Rath Goura K
Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Department of Hemato oncology, Tata Memorial Centre, Kolkata, West Bengal, India.
Indian J Med Paediatr Oncol. 2017 Jan-Mar;38(1):51-58. doi: 10.4103/0971-5851.203500.
This consensus document is based on the guidelines related to the management of Non Hodgkin's Lymphoma (High grade) in the Indian population as proposed by the core expert committee. Accurate diagnosis in hematolymphoid neoplasm requires a combination of detailed history,clinical examination, and various investigations including routine laboratory tests, good quality histology section (of tumor and also bone marrow aspirate/biopsy), immunostaining, cytogenetic and molecular studies and radiology investigations. The staging system used for adult high grade lymphomas is based on the Ann Arbor system and includes various parameters like clinical, haematology, biochemistry, serology and radiology. Response should be evaluated with radiological evaluation after 3-4 cycles and at the end of treatment based on criteria including and excluding PET. Treatment of high grade lymphomas is based on histologic subtype, extent of disease, and age of the patient. Autologous stem cell transplantation after high dose chemotherapy is effective in the treatment of relapsed NHL. Newer RT techniques like 3 dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) can significantly reduce radiation doses to surrounding normal tissues in lymphoma patients. Patients should be followed up every 3 to 4 months for the first 2 years, followed by 6 monthly for the next 3 years and then annually.
本共识文件基于核心专家委员会提出的印度人群非霍奇金淋巴瘤（高级别）管理指南。血液淋巴系统肿瘤的准确诊断需要详细病史、临床检查以及包括常规实验室检查、高质量组织学切片（肿瘤及骨髓穿刺/活检）、免疫染色、细胞遗传学和分子研究以及放射学检查在内的各种检查相结合。用于成人高级别淋巴瘤的分期系统基于安阿伯系统，包括临床、血液学、生物化学、血清学和放射学等各种参数。应在3 - 4个周期后以及治疗结束时根据包括和排除PET的标准通过放射学评估来评估反应。高级别淋巴瘤的治疗基于组织学亚型、疾病范围和患者年龄。大剂量化疗后的自体干细胞移植对复发性非霍奇金淋巴瘤的治疗有效。三维适形放射治疗（3D - CRT）和调强放射治疗（IMRT）等新型放疗技术可显著降低淋巴瘤患者周围正常组织的辐射剂量。患者应在头2年每3至4个月随访一次，接下来3年每6个月随访一次，然后每年随访一次。
