Diffuse large B-cell lymphoma (DLBCL) is the most common
non-Hodgkin's lymphoma, accounting for approximately 25-30% of all new patients.
Rituximab, a genetically engineered chimeric
monoclonal antibody that specifically binds to CD20, is the first
monoclonal antibody approved for the treatment of
B-cell lymphoma.
Rituximab significantly improves treatment outcome in DLBCL. A large-phase III study demonstrated improved overall survival (OS) in patients with DLBCL treated with R-CHOP
therapy. The Groupe d'Etude des Lymphomes de l'Adulte (GELA), Eastern Cooperative Oncology Group (ECOG) and German High-Grade
Non-Hodgkin Lymphoma Study Group (DSHNHL) studies designed for patients older than 60 years have clearly shown prolonged event-free survival (EFS) and OS among patients who received
rituximab and
chemotherapy. For patients under 60 years, the
MabThera International Trial Group (MInT) study demonstrated improved EFS and OS after the addition of
rituximab to CHOP
therapy. However, the R-CHOP
therapy does not provide a satisfactory treatment outcome in the high-risk group according to the international prognostic index. Therefore, R-CHOP
therapy is the new standard
therapy in elderly and young, low-risk DLBCL patients. For young, high-risk DLBCL patients, treatment that incorporates
rituximab and
hematopoietic stem cell transplantation has been administered in clinical studies.