Image of patient with primary refractory disease

Case #1:

Patient with
primary refractory disease*

Not an actual patient.

Treatment History

  • First-line treatment: 4 cycles
    (out of 6) of R⁠-⁠CHOP1
  • Progressed after 4 cycles of
    first⁠-⁠line therapy

Treatment Considerations

Disease severity2

  • Rapidly progressing primary refractory disease*
  • IPI: 3 (intermediate-high to high risk)
  • Ann Arbor Stage: 3

Performance status/age2,3

  • ECOG: 1
  • Aged 65 years

Comorbidities

  • Hypertension4

Patient considerations

  • Declined ASCT based on preference to stay with local care team, but still seeking further treatment

This is a hypothetical patient profile.

R⁠-⁠CHOP=rituximab/cyclophosphamide/hydroxydaunomycin/oncovin/prednisone; IPI=International Prognostic Index; ECOG=Eastern Cooperative Oncology Group; ASCT=autologous stem cell transplant.

*L-MIND included only patients whose DLBCL relapsed or progressed after at least 3 months from completion of prior CD20-containing therapy.5

Image of patient with primary refractory disease

Case #2:

Patient with chemorefractory disease

Not an actual patient.

Treatment History

  • First-line treatment: 6 cycles of R⁠-⁠CHOP1
  • CR achieved following R⁠-⁠CHOP; progressed 6 months after completion of first⁠-⁠line therapy1
  • Salvage chemotherapy failed to induce a response, ineligible for ASCT, and performance status ECOG 2 declined following chemotherapy3

Treatment Considerations

Disease severity2,5

  • IPI: 3 (intermediate-high to high risk)
  • Ann Arbor Stage: 3
  • Elevated LDH
  • Bulky disease

Performance status/age2,3

  • ECOG: 1
  • Aged 68 years

Comorbidities

  • Anemia

Patient considerations

  • Wants to initiate treatment quickly
  • Lives in a rural area

This is a hypothetical patient profile.

R⁠-⁠CHOP=rituximab/cyclophosphamide/hydroxydaunomycin/oncovin/prednisone; CR=complete response rate; ASCT=autologous stem cell transplant; ECOG=Eastern Cooperative Oncology Group; IPI=International Prognostic Index; LDH=lactate dehydrogenase.

Image of patient with primary refractory disease

Case #3:

Patient with R/R disease and comorbidities

Not an actual patient.

Treatment History

  • First-line treatment: 6 cycles of frontline R⁠-⁠mini⁠-⁠CHOP1
  • Complete response achieved following R⁠-⁠mini⁠-⁠CHOP1
  • Relapsed disease with symptoms 3 years after achieving CR
  • Ineligible for ASCT due to age and comorbidities3

Treatment Considerations

Disease severity2

  • IPI: 2 (low to low-intermediate risk)
  • Ann Arbor Stage: 3

Performance status/age2,3

  • ECOG: 2
  • Aged 75 years

Comorbidities4

  • Hypertension
  • Atrial fibrillation (with pacemaker)
  • Cardiac failure

Patient considerations

  • Looking for tumor reduction and symptom relief

This is a hypothetical patient profile.

R⁠-⁠CHOP=rituximab/cyclophosphamide/hydroxydaunomycin/oncovin/prednisone; CR=complete response rate; ASCT=autologous stem cell transplant; IPI=International Prognostic Index; ECOG=Eastern Cooperative Oncology Group.