First-line antitumor therapy for diffuse large B-cell lymphoma: results of the Moscow oncology registry analysis from 2022 to 2025

Marat A. Mingalimov; Мингалимов Марат Альбертович; E. A. Baryakh; Барях Е. А.; S. M. Gadzhieva; Гаджиева С. М.; E. N. Misyurina; Мисюрина Е. Н.; V. V. Ptushkin; Птушкин В. В.; M. S. Orlova; Орлова М. С.; D. V. Lebedev; Лебедев Д. В.; E. I. Bakaneva; Баканева Е. И.; P. S. Chernova; Чернова П. С.; D. D. Steposhina; Степошина Д. Д.; S. I. Geydarova; Гейдарова С. И.; A. A. Akhmadeeva; Ахмадеева А. А.; K. Kh. Akaeva; Акаева К. Х.; T. N. Tolstykh; Толстых Т. Н.; T. S. Chudnova; Чуднова Т. С.; D. D. Ivanova; Иванова Д. Д.; O. L. Kochneva; Кочнева О. Л.; L. T. Shimanovskaya; Шимановская Л. Т.; E. N. Zotina; Зотина Е. Н.; A. B. Makeshova; Макешова А. Б.; G. A. Dudina; Дудина Г. А.; N. G. Chernova; Чернова Н. Г.; A. V. Nekrasova; Некрасова А. В.; T. A. Semina; Семина Т. А.; M. A. Lysenko; Лысенко М. А.

doi:10.17650/1818-8346-2026-21-2-14-24

First-line antitumor therapy for diffuse large B-cell lymphoma: results of the Moscow oncology registry analysis from 2022 to 2025

Authors: Mingalimov M.A.¹^,2^,3, Baryakh E.A.¹^,2^,3^,4, Gadzhieva S.M.⁵, Misyurina E.N.¹^,2, Ptushkin V.V.⁶, Orlova M.S.², Lebedev D.V.¹, Bakaneva E.I.², Chernova P.S.², Steposhina D.D.², Geydarova S.I.², Akhmadeeva A.A.¹, Akaeva K.K.², Tolstykh T.N.¹^,2^,3, Chudnova T.S.¹^,2^,3, Ivanova D.D.¹, Kochneva O.L.¹^,3, Shimanovskaya L.T.¹, Zotina E.N.¹^,2^,3, Makeshova A.B.¹^,2^,3, Dudina G.A.⁷, Chernova N.G.⁴^,8, Nekrasova A.V.⁵, Semina T.A.⁵, Lysenko M.A.¹
Affiliations:
1. Moscow City Clinical Hospital No. 52, Moscow Healthcare Department
2. I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
3. Vavilov Institute of General Genetics, Russian Academy of Sciences
4. Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
5. Moscow Center for Monitoring and Development of Medical Care
6. Botkin Hospital, Moscow Healthcare Department
7. Moscow Clinical Scientific and Practical Center named after A. S. Loginov, Moscow Healthcare Department
8. Moscow Multidisciplinary Clinical Center “Kommunarka”, Moscow Healthcare Department
Issue: Vol 21, No 2 (2026)
Pages: 14-24
Section: HEMATOLOGIC MALIGNANCIES: TREATMENT
Published: 25.06.2026
URL: https://oncohematology.abvpress.ru/ongm/article/view/1080
DOI: https://doi.org/10.17650/1818-8346-2026-21-2-14-24
ID: 1080

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Abstract

Aim. To evaluate the structure and effectiveness of therapy for newly diagnosed diffuse large B-cell lymphoma (DLBCL) in adults in real clinical practice according to the Moscow Oncology Registry data.

Materials and methods. Data from 1060 patients with newly diagnosed DLBCL from the Moscow Oncology Registry who received treatment from 2022 to 2025 in a Moscow healthcare setting were retrospectively analyzed. The median age was 69 years. The majority of patients were in the older age group (60.4 %), with advanced disease stages (70 %), non-GCB subtypes (60 %), and high risk according to the international prognostic index (67 %). Of all patients included, 62.1 % received immunochemotherapy according to the R-CHOP program (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone), 12.6 % received R-DA-EPOCH (rituximab, etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin), 2.6 % received intensive regimens, 14.7 % received R-miniCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone in reduced doses), 7.8 % received RB (rituximab, bendamustine) or R-CVP (rituximab, cyclophosphamide, vincristine, prednisolone).

Results. In the overall patient cohort (n = 1060), the objective response rate was 79.7 % (n = 845). Complete metabolic response was achieved by 66.4 % (n = 704) of patients. The complete response rate varied depending on the treatment regimen: in the R-CHOP group it was 68.4 % (n = 451), when using R-DA-EPOCH – 69.4 % (n = 93), intensive regimens – 89.3 % (n = 25). Among patients receiving R-miniCHOP, complete response was achieved in 62.2 % (n = 97) of cases, while in the RB / R-CVP group this rate was the lowest and amounted to 45.8 % (n = 38). With a median follow-up of 24 months, the 2-year overall survival in the total group was 70 % (95 % confidence interval 67–73), and the 2-year progression-free survival was 44 % (95 % confidence interval 40–48).

Conclusion. Results of first-line DLBCL therapy efficacy analysis indicate unsatisfactory treatment outcomes, particularly in the high-risk group for early progression. We suggest that biologically targeted antitumor therapy based on the identified tumor genotype represents the most promising clinical approach for patients with newly diagnosed DLBCL.

Keywords

diffuse large B-cell lymphoma, routine clinical practice, efficacy of antitumor immunochemotherapy, patient registry

References

Alaggio R., Amadori S., Anagnostopoulos I. et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia 2022;36(7):1720–48. doi: 10.1038/s41375-022-01620-2
Wang S.S. Epidemiology and etiology of diffuse large B-cell lymphoma. Semin Hematol 2023;60(5):255–66. doi: 10.1016/j.semhematol.2023.11.001
Teras L.R., DeSantis C.E., Cerhan J.R. et al. 2016 US lymphoid malignancy statistics by World Health Organization subtypes. CA Cancer J Clin 2016;66(6):443–59. doi: 10.3322/caac.21357
Ministry of Health of Russia. Clinical guidelines for the diagnosis and treatment of aggressive B-cell lymphomas (KР129_3). Available at: https://cr.minzdrav.gov.ru/viewcr/129_3 (accessed April 12, 2025) (In Russ.).
Cai W., Zeng Q., Zhang X., Ruan W. Trends analysis of non-Hodgkin lymphoma at the national, regional, and global level, 1990–2019: results from the Global Burden of Disease Study 2019. Front Med (Lausanne) 2021;8:738693. doi: 10.3389/fmed.2021.738693
Sehn L.H., Salles G. Diffuse large B-cell lymphoma. N Engl J Med 2021;384(9):842–58. doi: 10.1056/NEJMra2027612
Eyre T.A., Cwynarski K., d’Amore F. et al. Lymphomas: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2025;36(11):1263–84. doi: 10.1016/j.annonc.2025.07.014
Coiffier B., Sarkozy C. Diffuse large B-cell lymphoma: R-CHOP failure-what to do? Hematology Am Soc Hematol Educ Program 2016;2016(1):366–78. doi: 10.1182/asheducation-2016.1.366
Kaplanov K.D., Volkov N.P., Klitochenko T.Y. et al. Analysis results of the regional registry of patients with diffuse large B-cell lymphoma: risk factors and chemo-immunotherapy issues. Klinicheskaya onkogematologiya. Fundamentalnye issledovaniya i klinicheskaya praktika = Clinical Oncohematology. Basic Research and Clinical Practice 2019;12(2):154–64. (In Russ.). doi: 10.21320/2500-2139-2019-12-2-154-164
Mingalimov M.A., Baryakh E.A., Polyakov Y.Y. et al. Treatment of diffuse large B-cell lymphoma at the Moscow City Clinical Hospital No. 52: a retrospective clinical trial based on the single-center experience and analysis of data from its in-house registry. Klinicheskaya onkogematologiya. Fundamentalnye issledovaniya i klinicheskaya praktika = Clinical Oncohematology. Basic Research and Clinical Practice 2024;17(1):11–17. (In Russ.). doi: 10.21320/2500-2139-2024-17-1-11-17
Cheson B.D., Fisher R.I., Barrington S.F. et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014;32(27):3059–68. doi: 10.1200/JCO.2013.54.8800
Ekström Smedby K., Eloranta S., Wästerlid T. et al. The National Swedish Lymphoma Register – a systematic validation of data quality. Acta Oncol 2024;63:563–72. doi: 10.2340/1651-226X.2024.40431
Durmaz M., Visser O., Posthuma E.F.M. et al. Time trends in primary therapy and relative survival of diffuse large B-cell lymphoma by stage: a nationwide, population-based study in the Netherlands, 1989–2018. Blood Cancer J 2022;12(3):38. doi: 10.1038/s41408-022-00637-1
Storti S., Spina M., Pesce E.A. et al. Rituximab plus bendamustine as front-line treatment in frail elderly (>70 years) patients with diffuse large B-cell non-Hodgkin lymphoma: a phase II multicenter study of the Fondazione Italiana Linfomi. Haematologica 2018;103(8):1345–50. doi: 10.3324/haematol.2017.186569
Braulke F., Zettl F., Ziepert M. et al. First-line treatment with bendamustine and rituximab for old and frail patients with aggressive lymphoma: results of the B-R-ENDA trial. Hemasphere 2022;6(12):e808. doi: 10.1097/HS9.0000000000000808
Wästerlid T., Murphy S., Villa D., El-Galaly T.C. Diffuse large B-cell lymphoma among the elderly: a narrative review of current knowledge and future perspectives. Ann Lymphoma 2022;6:6. doi: 10.21037/aol-22-2
Cunningham D., Hawkes E.A., Jack A. et al. Rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone in patients with newly diagnosed diffuse large B-cell lymphoma: a phase 3 comparison of dose intensification with 14-day versus 21-day cycles. Lancet 2013;381(9880):1817–26. doi: 10.1016/S0140-6736(13)60313-X
Peyrade F., Jardin F., Thieblemont C. et al. Attenuated immunochemotherapy regimen (R-miniCHOP) in elderly patients older than 80 years with diffuse large B-cell lymphoma: a multicentre, single-arm, phase 2 trial. Lancet Oncol 2011;12(5):460–8. doi: 10.1016/S1470-2045(11)70069-9
Bartlett N.L., Wilson W.H., Jung S.H. et al. Dose-adjusted EPOCH-R compared with R-CHOP as frontline therapy for diffuse large B-cell lymphoma: clinical outcomes of the phase III intergroup trial alliance/CALGB 50303. J Clin Oncol 2019;37(21):1790–9. doi: 10.1200/JCO.18.01994
Corazzelli G., Frigeri F., Russo F. et al. RD-CODOX-M/IVAC with rituximab and intrathecal liposomal cytarabine in adult Burkitt lymphoma and “unclassifiable” highly aggressive B-cell lymphoma. Br J Haematol 2012;156(2):234–44. doi: 10.1111/j.1365-2141.2011.08947.x
McMillan A.K., Phillips E.H., Kirkwood A.A. et al. Favourable outcomes for high-risk diffuse large B-cell lymphoma (IPI 3-5) treated with front-line R-CODOX-M/R-IVAC chemotherapy: results of a phase 2 UK NCRI trial. Ann Oncol 2020;31(9):1251–9. doi: 10.1016/j.annonc.2020.05.016
Dunleavy K., Pittaluga S., Maeda L.S. et al. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N Engl J Med 2013;368(15):1408–16. doi: 10.1056/NEJMoa1214561
Dabrowska-Iwanicka A., Nowakowski G.S. DLBCL: who is high risk and how should treatment be optimized? Blood 2024;144(25):2573–82. doi: 10.1182/blood.2023020779
Crump M., Neelapu S.S., Farooq U. et al. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood 2017;130(16):1800–8. doi: 10.1182/blood-2017-03-769620
Maurer M.J., Ghesquières H., Jais J.P. et al. Progression-free survival at 24 months (PFS24) and subsequent outcome for patients with diffuse large B-cell lymphoma enrolled on randomized clinical trials. Ann Oncol 2018;29(8):1822–7. doi: 10.1093/annonc/mdy203
Tilly H., Morschhauser F., Sehn L.H. et al. Polatuzumab vedotin in previously untreated diffuse large B-cell lymphoma. N Engl J Med 2022;386(4):351–63. doi: 10.1056/NEJMoa2115304
Zhang M.C., Tian S., Fu D. et al. Genetic subtype-guided immunochemotherapy in diffuse large B cell lymphoma: the randomized GUIDANCE-01 trial. Cancer Cell 2023;41(10): 1705–16.e5. doi: 10.1016/j.ccell.2023.09.004
Daneels W., Rosskamp M., Macq G. et al. Real-world estimation of first- and second-line treatments for diffuse large B-cell lymphoma using health insurance data: a Belgian population-based study. Front Oncol 2022;12:824704. doi: 10.3389/fonc.2022.824704
Ghesquieres H., Cherblanc F., Belot A. A large French real world multicentric prospective cohort of patients with lymphoma (REALYSA study): description of the diffuse large B cell lymphoma patients in real world in France. Hemasphere 2022;6(4):1072–3. doi: 10.1097/01.HS9.0000847608.68270.ea
Sineshaw H.M., Zettler C.M., Prescott J. et al. Real-world patient characteristics, treatment patterns, and treatment outcomes of patients with diffuse large B-cell lymphoma by line of therapy. Cancer Med 2024;13(7):e7173. doi: 10.1002/cam4.7173
Nair R., Bhurani D., Rajappa S. et al. Diffuse large B-cell lymphoma: clinical presentation and treatment outcomes from the OncoCollect lymphoma registry. Front Oncol 2022;11:796962. doi: 10.3389/fonc.2021.796962
Pavlovsky M., Cubero D., Agreda-Vásquez G.P. et al. Clinical outcomes of patients with B-cell non-Hodgkin lymphoma in real-world settings: findings from the hemato-oncology Latin America observational registry study. JCO Glob Oncol 2022;8:e2100265. doi: 10.1200/GO.21.00265

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First-line antitumor therapy for diffuse large B-cell lymphoma: results of the Moscow oncology registry analysis from 2022 to 2025

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Abstract

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About the authors

References

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