Treatment of Primary Ovarian Lymphoma in Diffuse Large B-Cell Lymphoma with Cardiac Comorbidities

Clinical Scenario

This protocol addresses patients with primary ovarian lymphoma arising in the context of diffuse large B-cell lymphoma (DLBCL) who have cardiac comorbidities that make them unsuitable for standard anthracycline-containing chemotherapy.

    Key clinical consideration: When cardiac comorbidities preclude anthracycline use in DLBCL, an individualised non-anthracycline regimen is recommended rather than the standard first-line approach.
  

Treatment Approach

For patients unsuitable for anthracyclines, an individualised non-anthracycline-based regimen is selected — typically delivered over six cycles or guided by an interim PET (iPET)-adapted strategy. Several rituximab-containing combination options exist for this situation. The specific regimen selection and sequencing are detailed in the full structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2025.07.014

For patients unsuitable for treatment with anthracyclines, an individualised regimen can be recommended:

R—cyclophosphamide—etoposide—vincristine—prednisone (R-CEOP) for six cycles or using an interim PET (iPET)-adapted strategy [III, B].

R—cyclophosphamide—non-pegylated liposomal doxorubicin—vincristine—prednisone (R-COMP) for six cycles or using an iPET-adapted strategy [III, B].

R—gemcitabine—cyclophosphamide—vincristine—prednisone (R-GCVP) for six cycles or using an iPET-adapted strategy [III, B].

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