Patients with primary Sjögren syndrome carry an elevated risk of B-cell lymphoma development. When that lymphoma is diffuse large B-cell lymphoma (DLBCL) — a moderate-to-high-grade haematological neoplasia — the clinical picture calls for a distinct management strategy.
This protocol addresses the treatment of Sjögren syndrome in the specific setting of concurrent diffuse large B-cell lymphoma.
Three subtypes of B-cell lymphoma account for more than 90% of reported cases in primary Sjögren syndrome: MALT lymphoma, other marginal zone lymphomas, and diffuse large B-cell lymphoma. DLBCL represents a moderate-to-high-grade category within this spectrum and places the patient in a distinct therapeutic group that differs from lower-grade subtypes.
For Sjögren syndrome patients with diffuse large B-cell lymphoma, the haematological grade of the neoplasia is central to treatment selection. Management involves a rituximab-based chemotherapy regimen —
DOI: 10.1136/annrheumdis-2019-216114