NCCN Guidelines for Patients® | Diffuse Large B-cell Lymphoma

43 NCCN Guidelines for Patients ® : Diffuse Large B-cell Lymphoma, 2017 4 Treatment guide First-line treatment | Follow-up care Guide 5. First-line treatment for stages III & IV Immunochemotherapy Results Treatment 2–4 cycles out of 6 planned cyles of: • RCHOP or • RCEPP • RCDOP • DA-EPOCH + rituximab • RCEOP • RGCVP • R-mini-CHOP No signs of cancer or cancer looks smaller on scans • Complete treatment • Clinical trial Cancer looks the same or larger; No cancer is found with biopsy • Complete treatment • Clinical trial Cancer looks the same or larger; Cancer is found with biopsy or biopsy is not done • Second-line treatment ( Guide 8 ) • Radiation therapy in some cases Guide 6. Extra treatment What are the options? • Wait and watch • Consider radiation therapy • Consider lenalidomide maintenance • Consider blood stem cell transplant if likely to relapse Guide 7. Follow-up care Type of care How often is this care needed? Medical history and physical exam • Every 3–6 months for 5 years ◦◦ If normal, then repeat every year or when needed Lab tests • Every 3–6 months for 5 years ◦◦ If normal, then repeat every year or when needed CT scan • As needed for stages I & II • No more often than every 6 months for 2 years or as needed for stages III and IV

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