Primary hepatic diffuse large B-cell lymphoma (DLBCL) is the predominant histological subtype of primary hepatic lymphoma and is managed primarily with systemic therapy. When first-line R-CHOP-based chemotherapy fails to produce a complete response, a defined second-line protocol is indicated.
A confirmed diagnosis of primary hepatic diffuse large B-cell lymphoma (DLBCL). Treatment approach is guided by disease histology; DLBCL is the predominant subtype and is managed with systemic therapy as the primary modality.
First-line treatment: R-CHOP (systemic chemotherapy).
Goal not achieved: complete response of the primary hepatic lymphoma (Deauville score 1–2).
Non-achievement of this target is the trigger for escalation to the next protocol.
Complete remission of the primary hepatic lymphoma.
The protocol involves a second-line intensive systemic combination regimen combined with radiation therapy. The complete regimen structure, sequencing, and all clinical decision criteria are contained in the full protocol.
DOI: 10.3389/fonc.2025.1475118
The treatment approach to PHL is guided essentially by the disease histology, with diffuse large B-cell lymphomas (DLBCL) treated primarily with systemic therapy and indolent lymphomas treated with various modalities including observation, surgery or systemic therapy.
DLBCL is the predominant histology observed among primary hepatic lymphomas.
However, the patient maintained complete remission for 3 years after receiving second-line R-HyperCVAD (rituximab, cyclophosphamide, vincristine, doxorubicin, methotrexate, cytarabine and dexamethasone)/R-HD MTX ara-C regimen (high dose methotrexate and cytarabine) with radiation therapy (40Gy for 28 fractions).
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