NCCN Guidelines Insights: B-Cell Lymphomas, Version 3.2019

Featured Updates to the NCCN Guidelines

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Diffuse large B-cell lymphomas (DLBCLs) and follicular lymphoma (FL) are the most common subtypes of B-cell non-Hodgkin’s lymphomas in adults. Histologic transformation of FL to DLBCL (TFL) occurs in approximately 15% of patients and is generally associated with a poor clinical outcome. Phosphatidylinositol 3-kinase (PI3K) inhibitors have shown promising results in the treatment of relapsed/refractory FL. CAR T-cell therapy (axicabtagene ciloleucel and tisagenlecleucel) has emerged as a novel treatment option for relapsed/refractory DLBCL and TFL. These NCCN Guidelines Insights highlight important updates to the NCCN Guidelines for B-Cell Lymphomas regarding the treatment of TFL and relapsed/refractory FL and DLBCL.

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  • 28.

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  • 29.

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  • 31.

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  • 32.

    Nowakowski GS, LaPlant B, Macon WR, . Lenalidomide combined with R-CHOP overcomes negative prognostic impact of non-germinal center B-cell phenotype in newly diagnosed diffuse large B-Cell lymphoma: a phase II study. J Clin Oncol 2015;33:251–257.

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  • 33.

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  • 34.

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  • 36.

    Neelapu SS, Locke FL, Bartlett NL, . Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. N Engl J Med 2017;377:2531–2544.

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  • 43.

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  • 49.

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  • 51.

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  • 52.

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  • 53.

    Clavert A, Le Gouill S, Brissot E, . Reduced-intensity conditioning allogeneic stem cell transplant for relapsed or transformed aggressive B-cell non-Hodgkin lymphoma. Leuk Lymphoma 2010;51:1502–1508.

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  • 54.

    Kridel R, Mottok A, Farinha P, . Cell of origin of transformed follicular lymphoma. Blood 2015;126:2118–2127.

  • 55.

    McPhail ED, Maurer MJ, Macon WR, . Inferior survival in high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements is not associated with MYC/IG gene rearrangements. Haematologica 2018;103:1899–1907.

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