Authors: P. Vodička; M. Trněný Authors‘ workplace: First Department of Medicine, First Faculty of Medicine, Charles University and General Hospital, Prague Published in: Transfuze Hematol. dnes,31, 2025, No. 4, p. 305-309. Category: Original Papers doi: https://doi.org/10.48095/cctahd202528
Management of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) has undergone significant transformation in recent years. Second line therapy has shifted from conventional salvage regimens toward immunotherapy-based approaches. CAR T-cell therapy is now the preferred option for patients with early relapse or primary refractory disease, while salvage chemoimmunotherapy followed by autologous stem cell transplantation consolidation remains reserved for younger, fit individuals with late relapses. Bispecific antibodies (BiAbs) combined with chemotherapy (i.e., glofitamab plus GemOx) offer effective alternatives for transplant-ineligible patients. Additional novel options include Pola-BR and tafasitamab-lenalidomide, particularly for elderly or frail individuals. In third line and later settings, treatment is increasingly individualized. CAR T-cell therapy remains the preferred modality if not previously administered; otherwise, BiAbs (glofitamab, epcoritamab, odronextamab), antibody-drug conjugates (loncastuximab tesirine, brentuximab vedotin), and lenalidomide-based regimens are considered. Real-world data from the NiHiL registry support the clinical utility of these novel agents and demonstrate improved survival outcomes following their integration into routine clinical practice.
relapse – Diffuse large B-cell lymphoma – therapy – real-world data – refractory
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AUTHOR CONTRIBUTION
PV – preparation of the first draft and final version of the manuscript
MT – critical revision of the manuscript
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest in connection with the topic, preparation and publication of this study. Preparation of the manuscript was not initiated or supported by any pharmaceutical company.
Declaration on the use of AI
Use of Artificial Intelligence in preparation of the manuscript – used for grammar correction.
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