Diffuse large B-cell lymphoma
ICD-10 C83.3 · ICD-11 2A81

Treatment of Diffuse Large B-Cell Lymphoma: Activated B-Cell (ABC, Non-GCB) Subtype

Diffuse large B-cell lymphoma can be classified into molecular subtypes at diagnosis. The activated B-cell (ABC), also referred to as the non-germinal-centre B-cell (non-GCB), subtype is a recognised biological group that informs treatment selection at the first-line setting.

Clinical scenario

This protocol applies to patients presenting with diffuse large B-cell lymphoma of the ABC (non-GCB) subtype. Subtype identification at diagnosis is central to selecting the appropriate first-line regimen for these patients.

Treatment approach — partial overview

First-line treatment for the ABC subtype involves an antibody-drug conjugate incorporated into a modified chemoimmunotherapy backbone. The modification to the backbone is made specifically to avoid overlapping toxicity with the added agent. The complete regimen, cycle structure, and clinical evidence base are detailed in the full protocol.

Full regimen specifics, including agents, sequencing, and supporting trial data, are available in the structured resource below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1038/s41408-026-01458-2

The patients with the ABC subtype should get 6 cycles of Pola-R-CHP chemotherapy.

Those with DLBCL—ABC subtype, are more typically treated with the antibody-drug conjugate, polatuzumab vedotin, added to R-CHP chemotherapy.

Recently however, the POLARIX study demonstrated an improved progression-free survival (PFS) when polatuzumab vedotin was added to R-CHP chemotherapy (vincristine omitted due to overlapping toxicity with polatuzumab vedotin).

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