429 R-CHOP chemotherapy is the standard treatment for DLBCL with a cure rate of over 60% [2]. Patients with limited disease have a five-year progression-free survival (PFS) ranging from 80%… Click to show full abstract
429 R-CHOP chemotherapy is the standard treatment for DLBCL with a cure rate of over 60% [2]. Patients with limited disease have a five-year progression-free survival (PFS) ranging from 80% to 85% while those with advanced disease have a five-year PFS of about 50% [4]. About 10 to 15% of patients treated with R-CHOP have primary refractory disease (an incomplete response or a relapse within six months after completing treatment) and an additional 20 to 25% will relapse after an initial response, typically within the first two years [2]. Patients with treatment failure after frontline therapies often have a poor outcome. DA-EPOCHR may be associated with improved outcomes in doubleor triple-hit high-grade B-cell lymphoma. Treatment with high-dose chemotherapy and autologous stem-cell transplantation (ASCT) offers the best chance of cure for patients with chemotherapy-sensitive relapsed or refractory disease [2, 4]. The prognosis of DLBCL depends on several variables such as age, LDH level, ECOG performance status, stage of disease and involvement of extranodal disease sites. Although data are limited, routine post-treatment surveillance imaging has not been shown to affect outcome. Patients who remain event-free for two years from the time of diagnosis have an expected overall survival similar to that of the ageand sex-matched general population [2]. However, patients should be monitored for long-term risks, including complications from infection, autoimmune disorders, secondary cancers, and cardiovascular events [2, 10, 11].
               
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