Primární mediastinální velkobuněčný B lymfom

Abstract

Primary mediastinal large B cell lymphoma is an aggressive tumor diagnosis characterized by a rapid increase of tumor mass in the anterior mediastinum, occurring in younger patients. Currently, at the time of immunochemotherapy, 5-year overall survival of patients is 80-90%, however relapse of the disease occurs early, usually within one year of the end of therapy and the prognosis of these patients is unsatisfactory. Positron emission tomography combined with computed tomography using ¹⁸F-fluorodeoxyglucose is currently widely used not only at the time of diagnosis but also for monitoring of response to treatment. The FDG PET/CT examination has a strong prognostic significance at the time of diagnosis, during treatment and after termination. There is the high importance of the consideration between the maximum efficacy of the therapy and reduction of the long-term toxicity risk. Standard, anthracycline-based immunochemotherapy (R-CHOP, DA-EPOCH-R), autologous stem cell transplantation or consolidation radiotherapy for residual tumor mass are currently standard of the therapy. New therapy modalities (PD1 inhibitors, brentuximab vedotin or CAR T cell therapy) are available, but needed clinical trials are ongoing to assess the effectivity.