Histology confirms DLBCL – MYC, BCL2 and BCL6 negative. He commences methylpred once the provisional histology is available and is managed for tumour lysis risk. He is then consented to CHOP- R chemo. He asks
‘will the chemotherapy cure the lymphoma?’
How do you respond? How do you counsel this patient regarding diagnosis/chemo/cure rates/ relapse rates?
We should also think about;
What other factors in this case influence the patients prognosis? Any scoring systems used to help determine this?
Intrathecal prophylaxis has been suggested for this patient. Which patients would you give intrathecal to? Use other CNS prophylaxis?