Table of contents

Diffuse large B-cell lymphoma (short version)

Date of document July 2022
This is the current valid version of the document


Diffuse large B-cell lymphoma is the most common neoplasm of the lymphatic system. It originates from mature B cells and rapidly leads to death if left untreated. Rapidly progressive lymph node enlargement and/or extranodal manifestations as well as general symptoms (B-symptoms) are characteristic.

The individual prognosis can be estimated using the International Prognostic Index.

The therapeutic goal is curative. First-line therapy consists of 6-8 cycles of the R-CHOP protocol or, depending on the risk profile, R-CHOP-like protocols. In early stages in the absence of risk factors, a reduction of treatment cycles is possible. The role of radiation has not been definitively determined. Other unresolved issues such as prognosis- or response-driven therapy, the value of more intensive treatment protocols, or the efficacy of new agents are the subject of prospective clinical trials.

The cure rate of patients with diffuse large B-cell lymphoma is approximately 60-70%.


The current treatment algorithm is depicted in Figure 1.

Figure 1: Treatment algorithm in patients with diffuse large B-cell lymphoma 
curative treatment intent; non-curative treatment intent;
* Involved site radiotherapy should be considered for circumscribed PET positive residual lymphoma.

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10Active studies

11Systemic Therapy – Protocols

12Study results

13Certification Status

15Authors' Affiliations

Prof. Dr. Georg Lenz
Universitätsklinikum Münster
Translationale Onkologie
Albert-Schweitzer-Campus 1, Gebäude D3
48149 Münster
Prof. Dr. med. Björn Chapuy
Charité – Universitätsmedizin Berlin
Medizinische Klinik mit Schwerpunkt
Hämatologie und Onkologie
Hindenburgdamm 30
12200 Berlin
Prof. Dr. med. Bertram Glaß
HELIOS Klinikum Berlin-Buch
Klinik für Hämatologie, Onkologie und Tumorimmunologie
Schwanebecker Chaussee 50
13125 Berlin
Prim. Univ.-Prof. Dr. Felix Keil
Hanusch Krankenhaus
Hämatologisch-onkologisches Zentrum
Heinrich-Collin-Straße 30
A-1140 Wien
Prof. Dr. Wolfram Klapper
Universitätsklinikum Schleswig-Holstein - Campus Kiel
Institut für Pathologie, Sektion für Hämatopathologie
Arnold-Heller-Str. 3, Haus 14
24105 Kiel
Dr. med. Maike Nickelsen
Onkologie Lerchenfeld
Lerchenfeld 14
22081 Hamburg
Prof. Dr. med. Heinz Schmidberger
Universitätsmedizin Mainz
Klinik für Radioonkologie und Strahlentherapie
Langenbeckstr. 1
55131 Mainz
Prof. Dr. med. Clemens A. Schmitt
Kepler Universitätsklinikum
Klinik für Interne 3 - Schwerpunkt Hämatologie und Onkologie
Krankenhausstr. 9
A-4021 Linz
Prof. Dr. med. Novak Urban
INSELSPITAL, Universitätsspital Bern
Klinik und Poliklinik für Medizinische Onkologie
Loryspital 1st floor, Rm130
CH-3010 Bern


Conflicts of interest can be found in the full German version of the guideline.