Community Oncologist

I am treating a double hit DLBCL. He has completed 6 cycles of da-repoch. His pet scan showed deauville score 2. What would you do next?

Non-Hodgkin Lymphoma Specialist

He is in complete remission. Any further therapy with either consolidative autologous transplant or maintenance therapy has not shown to improve OS. Therefore, no further treatment is recommended at this time. However, due to increased risk of relapse and poor outcomes in DHL, I repeat a PET scans at 6 months,1 year and 2 years from the end of treatment. If no evidence of relapse then the survival is comparable to age and sex matched controls after 2 years since end of treatment. If relapse is detected then CAR T-cell therapy is preferred over autologous transplant.