Дифузна B-великоклітинна лімфома, неуточнена (DLBCL NOS)
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DIS-DLBCL-NOS |
|---|---|
| Тип | Хвороба |
| Синоніми | DLBCLDLBCL NOSDiffuse Large B-Cell Lymphoma, Not Otherwise SpecifiedДифузна B-великоклітинна лімфома, неуточнена (DLBCL NOS)Дифузна великоклітинна B-клітинна лімфома |
| Статус | переглянуто 2026-04-25 | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-EHA-WORKUP-2024 SRC-NCCN-BCELL-2025 |
Інформаційна підтримка. Усі рекомендації має перевірити кваліфікований онколог. Технічні перевірки не є клінічною валідацією чи схваленням лікування.
| icd_o_3_morphology | 9680/3 |
|---|---|
| icd_o_3_topography | [] |
| icd_10 | C83.3 |
| who_classification | Aggressive B-cell lymphomas — Diffuse large B-cell lymphoma, NOS (DLBCL, NOS) per WHO Classification of Tumours of Haematolymphoid Tumours, 5th ed. |
Нотатки
Стратифікація за IPI (вік, ECOG, LDH, стадія, екстранодальні локалізації) та за клітиною-походження (GCB чи ABC за Hans IHC-алгоритмом). Первинна медіастинальна (PMBCL), первинна ЦНС-форма (PCNSL), трансформована з індолентної лімфоми та double-hit (HGBL) виділяються як біологічно окремі нозологічні одиниці — у межах Tier 1 розглядаються окремо.
Де використовується
Algorithms
ALGO-DLBCL-1L- ALGO-DLBCL-1LALGO-DLBCL-2L- ALGO-DLBCL-2LALGO-DLBCL-3L- ALGO-DLBCL-3L
Handbook Chapters
HB-DLBCL-1L- Diffuse large B-cell lymphoma: first-line reasoning
Questionnaires
QUEST-DLBCL-NOS-1L-STUB- Diffuse Large B-Cell Lymphoma, Not Otherwise Specified — first line
Sources
SRC-BEAUGERIE-CESAME-2013- Risk of new or recurrent cancer in patients with inflammatory bowel disease and previous...SRC-EPCORE-NHL-1-THIEBLEMONT-2023- Epcoritamab, a Novel, Subcutaneous CD3xCD20 Bispecific T-Cell-Engaging Antibody, in Relap...SRC-ESMO-DLBCL-2024- ESMO Clinical Practice Guideline on Diffuse Large B-Cell LymphomaSRC-ESMO-LYMPHOMA-2025- Lymphomas: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-upSRC-IDSA-EBV-2019- Post-transplant lymphoproliferative disorders, Epstein-Barr virus infection, and disease...SRC-MOZ-UA-LYMPH-2013- Уніфікований клінічний протокол первинної, вторинної (спеціалізованої) медичної допомоги:...SRC-NP30179-DICKINSON-2022- Glofitamab for Relapsed or Refractory Diffuse Large B-Cell LymphomaSRC-POLARIX-TILLY-2022- Polatuzumab Vedotin in Previously Untreated Diffuse Large B-Cell LymphomaSRC-TRANSFORM-KAMDAR-2022- Lisocabtagene maraleucel versus standard of care with salvage chemotherapy followed by au...
Клінічна застосовність
BMA-BCL2-EXPRESSION-DLBCL-NOS- High BCL2 IHC expression in DLBCL — common in GCB and ABC subsets. 'Dual-expressor' (BCL2...BMA-BCL2-REARRANGEMENT-DLBCL-NOS- Isolated BCL2 rearrangement in DLBCL (no MYC partner) — common in GCB-DLBCL transformed f...BMA-BRAF-V600E-DLBCL-NOS- BRAF V600E in DLBCL is exceptional. Tissue-agnostic dabrafenib + trametinib could be cons...BMA-IDH1-R132H-DLBCL-NOS- IDH1 R132H in DLBCL is exceptional (<1%). No targeted therapy in this indication; per usu...BMA-IDH2-R140Q-DLBCL-NOS- IDH2 R140Q in DLBCL is exceptional (<1%). No targeted therapy in this indication; per usu...BMA-MYC-REARRANGEMENT-DLBCL-NOS- Isolated MYC rearrangement in DLBCL (without BCL2/BCL6) — adverse prognostic but not equi...BMA-MYD88-L265P-DLBCL-NOS- MYD88 L265P in DLBCL marks the ABC/MCD molecular subtype (Schmitz et al. NEJM 2018; Wrigh...BMA-NOTCH1-ACTIVATING-DLBCL-NOS- NOTCH1 mutations in DLBCL — uncommon; not therapy-selecting.BMA-TP53-MUT-DLBCL-NOS- TP53-mut DLBCL — predicts R-CHOP failure; flag for early CAR-T pathway consideration at 2...BMA-TP53-R175H-DLBCL-NOS- TP53 hotspot in DLBCL — predicts R-CHOP failure; flag for early CAR-T. Hotspot R175H is a...BMA-TP53-R248Q-DLBCL-NOS- TP53 hotspot in DLBCL — predicts R-CHOP failure; flag for early CAR-T. Hotspot R248Q is a...BMA-TP53-R273H-DLBCL-NOS- TP53 hotspot in DLBCL — predicts R-CHOP failure; flag for early CAR-T. Hotspot R273H is a...BMA-TP53-R282W-DLBCL-NOS- TP53 hotspot in DLBCL — predicts R-CHOP failure; flag for early CAR-T. Hotspot R282W is a...
Показання
IND-CHRONIC-HIV-PREVENTION-ART- IND-CHRONIC-HIV-PREVENTION-ARTIND-CHRONIC-HIV-PREVENTION-OBSERVATION- IND-CHRONIC-HIV-PREVENTION-OBSERVATIONIND-DLBCL-1L-POLA-R-CHP- IND-DLBCL-1L-POLA-R-CHPIND-DLBCL-1L-RCHOP- IND-DLBCL-1L-RCHOPIND-DLBCL-1L-RCHOP-ISRT-EARLY- IND-DLBCL-1L-RCHOP-ISRT-EARLYIND-DLBCL-2L-LISOCEL- IND-DLBCL-2L-LISOCELIND-DLBCL-2L-POLA-R-BENDAMUSTINE- IND-DLBCL-2L-POLA-R-BENDAMUSTINEIND-DLBCL-3L-AXICEL-CART- IND-DLBCL-3L-AXICEL-CARTIND-DLBCL-3L-EPCORITAMAB- IND-DLBCL-3L-EPCORITAMABIND-DLBCL-3L-GLOFITAMAB- IND-DLBCL-3L-GLOFITAMABIND-DLBCL-3L-LISO-CEL-CART- IND-DLBCL-3L-LISO-CEL-CARTIND-DLBCL-3L-LONCASTUXIMAB- IND-DLBCL-3L-LONCASTUXIMABIND-DLBCL-RENAL-FAILURE-MOD-RCHOP- IND-DLBCL-RENAL-FAILURE-MOD-RCHOPIND-EMERG-INFUSION-REACTION-IRR- IND-EMERG-INFUSION-REACTION-IRRIND-IATROGENIC-ANTI-TNF-LYMPHOMA-PREVENTION-OBSERVATION- IND-IATROGENIC-ANTI-TNF-LYMPHOMA-PREVENTION-OBSERVATIONIND-IATROGENIC-ANTI-TNF-LYMPHOMA-PREVENTION-SURVEILLANCE- IND-IATROGENIC-ANTI-TNF-LYMPHOMA-PREVENTION-SURVEILLANCEIND-IATROGENIC-AZATHIOPRINE-LONGTERM-PREVENTION-OBSERVATION- IND-IATROGENIC-AZATHIOPRINE-LONGTERM-PREVENTION-OBSERVATIONIND-IATROGENIC-AZATHIOPRINE-LONGTERM-PREVENTION-SURVEILLANCE- IND-IATROGENIC-AZATHIOPRINE-LONGTERM-PREVENTION-SURVEILLANCEIND-IATROGENIC-METHOTREXATE-LONGTERM-LYMPHOMA-PREVENTION-OBSERVATION- IND-IATROGENIC-METHOTREXATE-LONGTERM-LYMPHOMA-PREVENTION-OBSERVATIONIND-IATROGENIC-METHOTREXATE-LONGTERM-LYMPHOMA-PREVENTION-SURVEILLANCE- IND-IATROGENIC-METHOTREXATE-LONGTERM-LYMPHOMA-PREVENTION-SURVEILLANCEIND-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-LONGTERM-PREVENTION-OBSERVATION- IND-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-LONGTERM-PREVENTION-OBSERVATIONIND-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-LONGTERM-PREVENTION-SURVEILLANCE- IND-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-LONGTERM-PREVENTION-SURVEILLANCEIND-OCC-GLYPHOSATE-PREVENTION-INTENSIFIED-SURVEILLANCE- IND-OCC-GLYPHOSATE-PREVENTION-INTENSIFIED-SURVEILLANCEIND-OCC-GLYPHOSATE-PREVENTION-OBSERVATION- IND-OCC-GLYPHOSATE-PREVENTION-OBSERVATIONIND-OCC-PCB-PREVENTION-INTENSIFIED-SURVEILLANCE- IND-OCC-PCB-PREVENTION-INTENSIFIED-SURVEILLANCEIND-OCC-PCB-PREVENTION-OBSERVATION- IND-OCC-PCB-PREVENTION-OBSERVATIONIND-UNIVERSAL-IMMUNOCOMPROMISED-PREVENTION-STRATIFIED-SCREENING- IND-UNIVERSAL-IMMUNOCOMPROMISED-PREVENTION-STRATIFIED-SCREENING
Тривожна ознака
RF-AAIPI-HIGH- Age-adjusted IPI ≥2 in patient <60 yo — high-risk young-adult DLBCL; supports DA-EPOCH-R...RF-CHRONIC-HIV-MALIGNANCY-PREVENTION- HIV infection (positive serology) in an individual without a current AIDS-defining or HIV...RF-DLBCL-CART-INELIGIBLE-POST-2L- Relapsed/refractory DLBCL post ≥2 prior systemic therapies, NOT a candidate for anti-CD19...RF-DLBCL-CD20-POS-EPCORITAMAB-CANDIDATE- Relapsed/refractory DLBCL with confirmed CD20 expression on malignant B-cells, post ≥2 pr...RF-DLBCL-CD20-POS-GLOFITAMAB-CANDIDATE- Relapsed/refractory DLBCL with confirmed CD20 expression on malignant B-cells, post ≥2 pr...RF-DLBCL-CD79B-MUT-MCD-CANDIDATE- CD79B mutation (most commonly Y196 hotspot in ITAM domain) in DLBCL, often co-occurring w...RF-DLBCL-CNS-RISK- DLBCL with high CNS-IPI risk (CNS-IPI ≥4) OR specific anatomic sites (testicular, breast,...RF-DLBCL-FRAILTY-AGE- Frailty profile precluding full-dose R-CHOP: ECOG ≥3, OR (age ≥80 with ≥1 grade-2 comorbi...RF-DLBCL-HIGH-IPI- DLBCL with International Prognostic Index ≥2 — selects intensified Pola-R-CHP over R-CHOP...RF-DLBCL-HIGH-RISK-BIOLOGY- High-risk biology in DLBCL NOS: double-expressor (MYC + BCL2 by IHC, no rearrangement), T...RF-DLBCL-INFECTION-SCREENING- Active or latent infection requiring resolution / prophylaxis before initiating R-CHOP-cl...RF-DLBCL-ORGAN-DYSFUNCTION- Baseline organ dysfunction precluding standard R-CHOP doses: LVEF <50% (anthracycline con...RF-DLBCL-TRANSFORMATION-PROGRESSION- Refractory or progressive DLBCL after ≥1 line of standard immunochemotherapy: primary ref...RF-IATROGENIC-ANTI-TNF-LYMPHOMA-PREVENTION- Chronic anti-TNF biologic exposure ≥3 years in pediatric, adolescent, or young-adult infl...RF-IATROGENIC-AZATHIOPRINE-LONGTERM-PREVENTION- Long-term thiopurine exposure ≥3-5 years — azathioprine or its active metabolite 6-mercap...RF-IATROGENIC-METHOTREXATE-LONGTERM-LYMPHOMA-PREVENTION- Long-term low-dose methotrexate exposure (≥1-2 years, ≥15 mg/week cumulative or PO 7.5-25...RF-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-LONGTERM-PREVENTION- Solid-organ transplant recipient on chronic immunosuppression ≥3 years post-transplant, b...RF-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-PREVENTION- Chronic immunosuppression for solid-organ transplant or post-allogeneic HSCT. Elevated ri...RF-IPI-HIGH- DLBCL with International Prognostic Index 4-5 (high risk) — supports Pola-R-CHP intensifi...RF-IPI-INTERMEDIATE- DLBCL with International Prognostic Index 2-3 (intermediate risk) — opens MDT discussion...RF-IPI-LOW- DLBCL with International Prognostic Index 0-1 (low risk) — supports R-CHOP standard backb...RF-OCC-GLYPHOSATE-PREVENTION- Documented historical occupational exposure to glyphosate-based herbicides (most notably...RF-OCC-PCB-PREVENTION- Documented historical occupational exposure to polychlorinated biphenyls (PCBs) — typical...RF-UNIVERSAL-IMMUNOCOMPROMISED-CANCER-RISK- Chronic immunosuppression ≥1 year — any of: (a) untreated or treated HIV with CD4 nadir <...
Хвороба
DIS-B-ALL- B-Lymphoblastic Leukemia / LymphomaDIS-BURKITT- Burkitt LymphomaDIS-CLL- Chronic Lymphocytic Leukemia / Small Lymphocytic LymphomaDIS-FL- Follicular LymphomaDIS-HGBL-DH- High-Grade B-Cell Lymphoma with MYC and BCL2 and/or BCL6 rearrangements (double-hit / triple-hit)DIS-NLPBL- Nodular Lymphocyte-Predominant B-cell Lymphoma (formerly NLPHL)DIS-PCNSL- Primary Diffuse Large B-Cell Lymphoma of the CNSDIS-PMBCL- Primary Mediastinal (Thymic) Large B-Cell LymphomaDIS-PTLD- Post-Transplant Lymphoproliferative Disorder