**6. Conclusions**

Despite the numerous advances and better understanding of the clinical, immunophenotypic, and genetic characteristics of DLBCL, but also in face of several breakthroughs in its treatment, the prognosis of this type of NHL has witnessed only modest improvements. The search for new biomarkers and efficient therapeutic agents in the context of future individualized treatment will be crucial in our quest for improved results.

#### **Acknowledgements**

All authors shared equal contribution to this chapter.

### **Conflict of interest**

None.

#### **Abbreviations**


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**Author details**

Patrascu Ana Maria1

Craiova, Romania

Craiova, Romania

provided the original work is properly cited.

*Diffuse Large B-Cell Lymphoma DOI: 10.5772/intechopen.85489*

DLBCL diffuse large B-cell lymphomas FOXP1 forkhead box protein P1 GCB DLBCL germinal center DLBCL

IRF4 interferon regulatory factor 4 MUM1 multiple myeloma 1 protein

PTL primary testicular lymphomas

prednisone

and prednisone WHO World Health Organization

, Ionela Rotaru1

\*Address all correspondence to: stef.patrascu@gmail.com

NHL non-Hodgkin lymphoma PDL 1 programmed death-ligand 1

GCET1 germinal center B cell-expressed transcript 1

PMBCL primary mediastinal large B-cell lymphoma

NFkB nuclear factor kappa-light-chain-enhancer of activated B cells

R-ACVBP adriamycin-cytoxan-vindesine-bleomycin-prednisone-rituximab

R-CHOEP rituximab, cyclophosphamide, doxorubicin, vincristine, etoposide,

PET-CT positron emission tomography-computed tomography

R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine,

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

, Valeriu Surlin2

1 Department of Hematology, University of Medicine and Pharmacy of Craiova,

2 Department of Surgery, University of Medicine and Pharmacy of Craiova,

and Stefan Patrascu2

\*

#### *Diffuse Large B-Cell Lymphoma DOI: 10.5772/intechopen.85489*

*Normal and Malignant B-Cell*

lower toxicity for CHOP was observed [32].

patient selected for individualized treatment protocol.

All authors shared equal contribution to this chapter.

significantly higher toxicity [33].

nib, and daratumumab [36–38].

quest for improved results.

**Acknowledgements**

**Conflict of interest**

None.

**Abbreviations**

ABC DLBCL activated B-cell DLBCL B2M beta-2 microglobulin Bcl-2 B-cell receptor 2 Bcl-6 B-cell receptor 6

CIITA class II MHC transactivator

CNS central nervous system

c-Myc avian myelocytomatosis virus oncogene cellular homolog

**6. Conclusions**

(cyclophosphamide, doxorubicin, etoposid, Cytosar, bleomycin, vincristine, methotrexate, prednisone) and M-BACOD (methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone), showed no benefits for complete remission or disease-free survival when compared to CHOP. However, a

The R-ACVBP regimen, consisting of rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone, for induction of remission, and consolidation with methotrexate, doxorubicin, and cyclophosphamide, was tested by the GELA (Groupe d'Etude des Lymphomes de l'Adulte) study on 379 patients. This regimen showed some advantages over the R-CHOP-21 but at the price of

Given these circumstances, there is a growing need for new therapeutic alternatives, fitted for the morphologic, immunohistochemical, and genetic profile of each

Despite the numerous advances and better understanding of the clinical, immunophenotypic, and genetic characteristics of DLBCL, but also in face of several breakthroughs in its treatment, the prognosis of this type of NHL has witnessed only modest improvements. The search for new biomarkers and efficient therapeutic agents in the context of future individualized treatment will be crucial in our

The role of immunophenotype variability for the therapeutic outcome has long been the cornerstone for DLBCL management strategy, largely because the treatment of lymphomas evolves toward new therapies (immunotherapy, targeted therapy), which is made possible by analyzing the biology and the signaling pathways of this disease [34, 35]. Furthermore, a growing number of biological agents are available, varying from interferon to rituximab or radiolabeled antibodies, but also the more recent acquisitions in targeted therapy, such as ibrutinib, acalabruti-

**100**

