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Annals of Oncology 9:S9-S14, 1998
© 1998 European Society for Medical Oncology

Reviews

High-dose therapy for diffuse large-cell lymphoma in first remission

A. R. Perry and A. H. Goldstone

University College London Hospitals London, UK

Correspondence to: Dr A. H. Goldstone, Department of Clinical Haematology, University College Hospital, Grafton Way, London WC1E 6AU UK

Diffuse large-cell lymphoma (DLCL) is curable by first-line conventional chemotherapy in 50%–60% of patients. High-dose therapy makes no contribution to this group of patients and, if applied indiscriminately as first-line consolidation therapy, is likely to unnecessarily increase overall morbidity and mortality. Instead, recent interest has been directed towards (a) the identification of a group of patients with a poor prognosis, and (b) the intensification of first-line treatment for such patients with high-dose therapy and allied regimens. Many prognostic factors have now been standardised, while studies are progressing in the identification of newer prognostic factors, such as the molecular markers. Multi-centre randomised trials are currently in progress to determine the appropriate level of treatment for prognostic subsets, with the value of high-dose therapy being assessed for those in the worst prognostic groups.

autologous transplantation, diffuse large-cell lymphoma, high-dose therapy, lymphoma, peripheral blood stem cell transplantation, prognostic factors


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