The concept of treatment‑free remission in chronic myeloid leukemia

Cancer research · Lymphoma

Diffuse large B‑cell lymphoma (DLBCL) is the most common subtype of non‑Hodgkin lymphoma.

Diffuse large B‑cell lymphoma (DLBCL) is the most common subtype of non‑Hodgkin lymphoma. Historically, radiation therapy (RT) served as the primary treatment modality for patients with localized disease. While still an option for select patients who are not candidates for systemic therapy, RT is currently used most frequently as a consolidation treatment after chemoimmunotherapy. Consolidation RT is most commonly recommended after an abbreviated course of systemic therapy in patients who have bulky disease or multiple risk factors, or in the setting of a partial response. Consolidation RT is also appropriate in some patients with advanced DLBCL, including those presenting with bulky disease (>7.5 cm). While many patients achieve sustained remissions after first‑line therapy, up to 50 % of patients with DLBCL will eventually relapse. The most common salvage options include second‑line chemotherapy followed by high‑dose chemotherapy and autologous stem cell transplantation (ASCT) and chimeric antigen receptor (CAR) T‑cell therapy. RT can be used in both settings to optimise clinical outcomes. This includes consolidation RT in patients with localised presentations or bulky disease in the setting of ASCT and bridging RT in select patients undergoing CAR T‑cell therapy. RT is also a valuable modality in any patient with symptomatic disease requiring palliation.

The statement establishes the prevalence of DLBCL and underscores the evolving role of radiation therapy—from early‑stage disease to refractory settings—highlighting its potential as both a consolidative and palliative modality in modern lymphoma management.

Evidence level: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.

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