The Fellow on Call: The Heme/Onc Podcast Episode 073: Management of Early Stage Diffuse Large B-Cell Lymphoma (DLBCL)
Sep 13, 2023
Explore the management of early stage Diffuse Large B-Cell Lymphoma with insights into diagnostic strategies like PET/CT scans and the Deauville score. A case study illustrates tailored treatment approaches that de-escalate therapy while ensuring effective outcomes. Discover advancements in treatment, evolving from traditional chemotherapy to modernized regimens, and how genetic factors influence decisions. Special considerations for older patients highlight the importance of personalized care in this complex field.
AI Snips
Chapters
Transcript
Episode notes
Immunophenotyping in Diagnosis
- CD10 positivity on flow cytometry suggests a germinal center origin lymphoma.
- Increased forward scatter indicates large cell size, generally correlating with more aggressive lymphoma like DLBCL.
Defining Early vs Advanced DLBCL
- Early stage DLBCL is defined by single nodal/extranodal involvement on the same side of the diaphragm without bulky disease.
- Bulk disease (typically >7.5-10 cm) and involvement across diaphragm indicates advanced stage, changing treatment approach.
PET-CT and Bone Marrow Biopsy Roles
- PET/CT and LDH are crucial for prognostication and staging in DLBCL.
- Bone marrow biopsy may be omitted if PET shows marrow avidity, as marrow involvement is inferred and management remains unchanged.