Diffuse large B-cell lymphoma: changing treatment paradigms.

Diffuse large B-cell lymphoma (DLBCL) was first cured with anthracycline-based chemotherapy in the 1970s. In the late 1990s, the addition of rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy increased 10-year overall survival by approximately 15%. Two decades of variations on chemotherapy regimens and dosing schedules and upfront transplant have demonstrated no significant additional improvement. Despite the diversity inherent in DLBCL, the current paradigm of treatment is rituximab + CHOP (R-CHOP) for all patients with DLBCL.