BC Cancer Centre for Lymphoid Cancer, Vancouver, British Columbia, Canada.
University of British Columbia, Vancouver, British Columbia, Canada.
Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-14. doi: 10.1200/EDBK_349307.
Diffuse large B-cell lymphoma and follicular lymphoma are the most commonly encountered non-Hodgkin lymphomas in clinical practice. Both are biologically heterogeneous, with management strategies that are becoming increasingly complex. Diffuse large B-cell lymphoma typically exhibits aggressive behavior but can be cured in the majority of cases with immunochemotherapy. While R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) has been the standard of care for decades, the recent combination of polatuzumab-vedotin-R-CHP (rituximab plus cyclophosphamide, doxorubicin, and prednisone) has demonstrated improved progression-free survival for patients with intermediate- and intermediate-high-risk disease. Numerous novel therapies, including targeted agents and immunotherapy-based approaches, have recently been approved for relapsed/refractory disease and have led to improved outcomes. Follicular lymphoma is an indolent lymphoma that remains incurable with standard approaches. Overall survival in most patients is excellent, although a proportion of patients will have early relapsing disease and poorer outcomes. The availability of novel agents in the relapsed/refractory setting has shifted the treatment algorithm, which requires thoughtful consideration of sequencing. This article will review recent developments in the treatment of diffuse large B-cell lymphoma and relapsed/refractory follicular lymphoma.
弥漫性大 B 细胞淋巴瘤和滤泡性淋巴瘤是临床实践中最常见的非霍奇金淋巴瘤。两者在生物学上均具有异质性，其管理策略变得越来越复杂。弥漫性大 B 细胞淋巴瘤通常表现出侵袭性行为，但在大多数情况下，采用免疫化学疗法可以治愈。虽然 R-CHOP（利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松）几十年来一直是标准治疗方法，但最近的 polatuzumab-vedotin-R-CHP（利妥昔单抗联合环磷酰胺、多柔比星和泼尼松）联合方案已证明可改善中危和中高危疾病患者的无进展生存期。许多新的治疗方法，包括靶向药物和免疫疗法，最近已被批准用于复发/难治性疾病，并改善了患者的预后。滤泡性淋巴瘤是一种惰性淋巴瘤，采用标准方法仍无法治愈。大多数患者的总生存期良好，尽管一部分患者会出现早期复发疾病和较差的预后。在复发/难治性疾病中新型药物的出现改变了治疗方案，需要仔细考虑药物的顺序。本文将综述弥漫性大 B 细胞淋巴瘤和复发/难治性滤泡性淋巴瘤的治疗新进展。
