Primary mediastinal large B-cell lymphoma

Czech version

Authors: V. Hanáčková ¹; F. Folber ²; L. Henzlová ³; P. Flodr ⁴; V. Procházka ¹
Authors‘ workplace: Hemato-onkologická klinika LF UP a FN Olomouc ¹; Interní hematologická a onkologická klinika LF MU a FN Brno ²; Klinika nukleární medicíny LF UP a FN Olomouc ³; Ústav klinické a molekulární patologie, LF UP a FN Olomouc ⁴
Published in: Transfuze Hematol. dnes,30, 2024, No. 4, p. 224-234.
Category: Review/Educational Papers
doi: https://doi.org/10.48095/cctahd2024prolekare.cz17

Overview

Primary mediastinal large B-cell lymphoma is an aggressive tumour characterized by a rapid increase of tumour mass in the anterior mediastinum that occurs in younger patients. Currently, in the age of immunochemotherapy, 5-year overall survival of patients is 80–90%. However, relapse occurs early, usually within one year from the end of therapy and the prognosis of these patients is unsatisfactory. Positron emission tomography combined with computed tomography using ¹⁸F-fluorodeoxyglucose is currently widely used not only at the time of diagnosis but also for monitoring response to treatment. The FDG PET/CT has a strong prognostic significance at the time of diagnosis, during treatment and after its termination. Maximum treatment efficacy and reduction of the long-term toxicity risk are key when selecting therapeutic modalities. Standard, anthracycline-based immunochemotherapy (R-CHOP, DA-EPOCH-R), autologous stem cell transplantation or consolidation radiotherapy for residual tumour mass are the current standard of the therapy. New modalities (PD1 inhibitors, brentuximab vedotin or CAR T cell therapy) are available, but require results from ongoing clinical trials to assess their effectivity.

Keywords:

radiotherapy – primary mediastinal large B-cell lymphoma – immunochemotherapy – positron- emission tomography

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