Diffuse Large B-Cell Lymphoma: Relapsed/Refractory
The term “relapsed” refers to disease that reappears or grows again after a period of The absence of disease. Remission does not necessarily indicate that a person is cured. Patients may have complete or partial remission..
The term “A cancer that is resistant to treatment.” is used to describe when the lymphoma does not respond to treatment (meaning that the Abnormal cell growth that cannot be controlled by the body's natural defenses. Cancerous cells can grow and eventually form tumors. cells continue to grow) or when the response to treatment does not last very long.
High-dose Treatment with drugs to stop the growth of rapidly dividing cancer cells, including lymphoma cells. followed by stem cell transplantation can be used to treat patients with DLBCL whose disease is refractory or relapsed following initial chemotherapy. The majority of patients undergoing stem cell transplantation will have an A type of bone marrow or stem cell transplantation in which a patient receives his or her own cells. (patient receives his or her own stem cells, collected prior to the procedure). Occasionally, a patient will undergo an A procedure in which a patient receives bone marrow or stem cells donated by another person. (patient receives stem cells from a donor).
For those relapsed/refractory patients Several drugs given together to increase response rate of certain tumors. regimens are available. These second-line regimens include:
- ifosfamide, carboplatin, and etoposide (ICE)
- dexamethasone, cisplatin, and cytarabine (DHAP)
- gemcitabine-based therapy
- bendamustine (Treanda) plus rituximab (Rituxan)
- lenalidomide (Revlimid) plus rituximab (Rituxan)
- polatuzumab vedotin-piiq (Polivy)*
*As of June 10, 2019, the U.S. Food and Drug Administration approved the use of polatuzumab vedotin-piiq (Polivy) for adults with relapsed/refractory DLBCL, after two prior therapies.
For some relapsed/refractory patients a form of Treatments that interact with the immune system. called chimeric Identifying proteins located on the surface of all cells. The immune system uses antigens to determine whether cells are a necessary part of the body or need to be destroyed. receptor (CAR) A type of white blood cell that participates in immune responses by destroying harmful substances or cells. therapy, may be a possible treatment option. The approved CAR T-cell therapies include:
- axicabtagene ciloleucel (Yescarta)
- tisagenlecleucel (Kymriah)
For those relapsed/refractory patients who have a subset of DLBCL called primary mediastinal large B-cell lymphoma (PMBCL). These second-line regimens include:
- pembrolizumab (Keytruda)
To learn more about relapsed/refractory DLBCL, download the Diffuse Large B-Cell Lymphoma Fact Sheet.