When and what is the ideal first-line therapy for low-grade B-cell non-Hodgkin lymphomas? (English)

Low-grade B-cell non-Hodgkin lymphomas (B-NHL) are malignant diseases of the lymphatic tissue, the diagnosis and treatment of which may involve not only the lymphoma specialist but also physicians of many other specialties. They constitute 35% of lymphomas and in each clinical entity of this group a wide range of clinical behavior and histological and or clinical progression can be observed at various times. For this reason, tumors of the lymphatic tissue are not currently classified in terms of low or high aggressiveness of biological behavior, and therapeutic crite ria vary, depending on the characteristics of the disease and of the patient. In general, asymptomatic patients with low-grade B-NHL and with no specific abnormalities on laboratory tests are initially monitored at regular intervals, as treatment at diagnosis has not been shown to improve the prognosis of the disease. First-line forms of treatment, when indicated according to the clinical and laboratory criteria or progression of the disease, include radiotherapy, chemotherapy and treatment with monoclonal antibodies, either as monotherapy or, more commonly, as combination therapy. At present, the clinician can and must choose from a wide variety of therapeutic options, since there does not appear to be one single treatment that is uniformly superior, either regarding the disease or the effects on the patients. With an ever-expanding range of therapeutic modalities, the specialized physician needs to remain familiar with the clinical expressions and course of these diseases in order to provide therapeutic interventions that are necessary, timely and successful. [ABSTRACT FROM AUTHOR]

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