Lecture 2020: DLBCL

Question 1

In the IPI scoring system, what are the unfavorable variables in DLBCL?

Answer 1

Age over 60
Stage III or IV
2 or more extranodal sites
2 or higher performance status
Elevated LDH

Question 2

Which generally has a worse prognosis in DLBCL?

ABC or GCB?

Answer 2

ABC

Question 3

What mutations constitute double hit DLBCL?

How does double hit affect prognosis

Answer 3

CMYC and (BCL2 or BCL6)

Prognosis is much worse

Question 4

How do you treat early stage DLBCL?

Answer 4

R-CHOP for 3 cycles followed by radiation
or
R-CHOP for 4 cycles without RT for low risk

Question 5

How do you trat advanced stage DLBCL?

Answer 5

6 cycles of R-CHOP

Question 6

Standard treatment for Primary Mediastinal Large B Cell Lymphoma and double hit DLBCL?

Answer 6

There isn’t an established regimen at this time and NCCN does not give a recommendation.
DA-EPOCH-R may be the best thing we have right now.

Question 7

How should you treat a relatively robust patient with 1st relapse DLBCL?

Answer 7

Give 2-4 cycles of chemotherapy (most are cisplatin-based) if the patient responds then plan for autologous stem cell transplant