Treatment of Transformed Follicular Lymphoma (Histological Transformation to DLBCL) in Anthracycline-Naive Patients

Clinical Scenario

This protocol addresses patients with follicular lymphoma that has undergone histological transformation to diffuse large B-cell lymphoma (DLBCL), where the patient is anthracycline-naive — meaning no prior anthracycline-containing chemotherapy has been given.

Patient Context

These patients may have been managed with watchful waiting or received only radiotherapy before transformation occurred. The absence of prior anthracycline-based treatment is the defining eligibility criterion for this treatment pathway.

Treatment Approach

For eligible patients, current guidance supports an immunochemotherapy-based approach, aligning this transformed presentation with the standard of care used in de novo DLBCL. The complete regimen, eligibility criteria, and clinical decision points are set out in the full structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

Offer R-CHOP to people with tFL who are anthracycline-naïve and can tolerate this therapy.
In a similar fashion, patients with tFL who have received no prior chemotherapy (i.e., those managed expectantly or who have received only radiotherapy) should be treated as de novo DLBCL [i.e. with R-CHOP (or similar) immunochemotherapy without HDT-ASCR].

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