Diffuse Large B-cell Lymphoma (DLBCL) Treatment Algorithm: Dr. Mazyar Shadman

Diffuse Large B-cell Lymphoma (DLBCL) treatment requires a strategic approach balancing frontline regimens with emerging therapies for relapsed or refractory disease. Frontline management centers on R-CHOP or Pola-R-CHOP, with the latter increasingly favored for patients with an IPI score of two or higher. For primary refractory cases or relapse within 12 months, CAR-T therapy represents the standard of care, offering curative potential. Clinicians must weigh the safety profiles of available CAR-T products, such as the lower toxicity of Liso-cel versus the rapid turnaround of Axi-cel. Beyond CAR-T, bispecific antibodies are gaining traction in earlier lines, though their use remains contingent on logistical access. Improving patient outcomes depends heavily on robust partnerships between community oncologists and tertiary care centers to ensure timely access to these advanced, life-saving interventions.