EBMT 2018 | Improving the treatment landscape for DLBCL patients

Regarding high risk patient groups, there are some clinical, biological or molecular abnormalities that result in a more aggressive disease or a less responsive disease. In particular, there are some subgroups of patients e.g. those with primary refractory disease, that experience progressive disease during the first 4-6 months from the start of the treatment. As this is a high-risk group of patients, the therapeutic results are very poor and these patients usually do not respond to salvage treatment. There are some studies looking for genetic abnormalities that can predict this group of high-risk patients in order to offer them a more intensive treatment. There are other groups of patients for example those with a high international prognostic index, which is the most commonly used prognosticator in these patients. In particular young patients with high scores exhibit poor survival figures. Some authorities then designed and executed a randomized Phase II trial comparing conventional chemotherapy with a more intensified treatment for autologous stem cell transplantation. The overall results of this randomized trial shows that even if there is an improvement in progression-free survival, there is no positive effect on overall survival thus the prognosis of these patients remain poor. This group of patients should be enrolled in prospective trials to improve our knowledge in this topic area.