DLBCL ESMO Guideline Exam
Questions with Answers
Which antibody-based maintenance therapy is not recommended for relapsed DLBCL
patients? - Answer-Rituximab
What is the typical follow-up schedule for DLBCL patients post-treatment? - Answer-
Every 3 months for 1 year, every 6 months for 2 more years, then annually
What should be included in the immunohistochemical panel for DLBCL diagnosis? -
Answer-CD20, CD79a, BCL6, CD10, MYC, BCL2, Ki67, IRF4, CyclinD1, CD5, CD23,
EBER-1
What is the significance of the Deauville criteria in DLBCL? - Answer-It is used for post-
treatment response assessment
What is the recommended diagnostic approach for DLBCL? - Answer-Surgical biopsy,
immunophenotypic investigations, assessment of B-cell monoclonality if needed
What blood tests are required for staging DLBCL? - Answer-Complete blood count,
routine blood chemistry, LDH, uric acid, HIV, HBV, and HCV screening
What are the risk categories of the IPI for DLBCL? - Answer-Low (0-1), Low
intermediate (2), High intermediate (3), High (4-5)
What is the recommended initial treatment for high-intermediate-risk young patients with
DLBCL? - Answer-Six to eight cycles of R-CHOP21
What additional measure may be considered for patients with bulky disease after initial
chemotherapy? - Answer-Involved-field radiotherapy (IF-RT)
What is a typical initial treatment for elderly patients with DLBCL? - Answer-R-CHOP21
What should be assessed before starting treatment in DLBCL patients? - Answer-
Cardiac function (left ventricular ejection fraction)
How often should patients with DLBCL undergo radiological examinations post-
treatment? - Answer-At 6, 12, and 24 months
What is recommended for high-risk DLBCL patients to prevent CNS relapse? - Answer-
Intravenous high-dose methotrexate
, What type of biopsy is preferred for diagnosis confirmation at relapse? - Answer-
Needle-core biopsy
What factors are critical in assessing the risk and treatment strategy for relapsed
DLBCL? - Answer-Initial prognostic factors, previous treatments, time from initial
treatment
What new agents show promise for treatment of molecular subtypes of DLBCL? -
Answer-Bortezomib, lenalidomide, ibrutinib
What defines the Ann Arbor Stage I classification? - Answer-Involvement of a single
lymphatic region or localized involvement of a single extralymphatic organ or site
What defines the Ann Arbor Stage II classification? - Answer-Involvement of two or
more lymphatic regions on the same side of the diaphragm or localized involvement of a
single extralymphatic organ or site and one or more lymphatic regions on the same side
of the diaphragm
What defines the Ann Arbor Stage III classification? - Answer-Involvement of lymphatic
regions on both sides of the diaphragm
What percentage of non-Hodgkin lymphoma series does DLBCL constitute? - Answer-
30%-58%
What is the crude incidence of DLBCL in Europe? - Answer-3.8/100,000/year
What increases the risk of DLBCL? - Answer-Family history of lymphoma, autoimmune
disease, HIV infection, HCV seropositivity, high body mass as a young adult, some
occupational exposures
What type of biopsy remains the optimal method of diagnosis for DLBCL? - Answer-
Surgical excision biopsy
What should be avoided as the sole basis for diagnosing DLBCL? - Answer-Fine-needle
aspirate
What must confirm a morphological diagnosis of DLBCL? - Answer-Immunophenotypic
investigations
What should be considered if there is doubt in the diagnosis of DLBCL? - Answer-
Demonstration of B-cell monoclonality by a PCR-based method
What is the recommended gold standard for staging DLBCL patients? - Answer-FDG-
PET/CT scan
Questions with Answers
Which antibody-based maintenance therapy is not recommended for relapsed DLBCL
patients? - Answer-Rituximab
What is the typical follow-up schedule for DLBCL patients post-treatment? - Answer-
Every 3 months for 1 year, every 6 months for 2 more years, then annually
What should be included in the immunohistochemical panel for DLBCL diagnosis? -
Answer-CD20, CD79a, BCL6, CD10, MYC, BCL2, Ki67, IRF4, CyclinD1, CD5, CD23,
EBER-1
What is the significance of the Deauville criteria in DLBCL? - Answer-It is used for post-
treatment response assessment
What is the recommended diagnostic approach for DLBCL? - Answer-Surgical biopsy,
immunophenotypic investigations, assessment of B-cell monoclonality if needed
What blood tests are required for staging DLBCL? - Answer-Complete blood count,
routine blood chemistry, LDH, uric acid, HIV, HBV, and HCV screening
What are the risk categories of the IPI for DLBCL? - Answer-Low (0-1), Low
intermediate (2), High intermediate (3), High (4-5)
What is the recommended initial treatment for high-intermediate-risk young patients with
DLBCL? - Answer-Six to eight cycles of R-CHOP21
What additional measure may be considered for patients with bulky disease after initial
chemotherapy? - Answer-Involved-field radiotherapy (IF-RT)
What is a typical initial treatment for elderly patients with DLBCL? - Answer-R-CHOP21
What should be assessed before starting treatment in DLBCL patients? - Answer-
Cardiac function (left ventricular ejection fraction)
How often should patients with DLBCL undergo radiological examinations post-
treatment? - Answer-At 6, 12, and 24 months
What is recommended for high-risk DLBCL patients to prevent CNS relapse? - Answer-
Intravenous high-dose methotrexate
, What type of biopsy is preferred for diagnosis confirmation at relapse? - Answer-
Needle-core biopsy
What factors are critical in assessing the risk and treatment strategy for relapsed
DLBCL? - Answer-Initial prognostic factors, previous treatments, time from initial
treatment
What new agents show promise for treatment of molecular subtypes of DLBCL? -
Answer-Bortezomib, lenalidomide, ibrutinib
What defines the Ann Arbor Stage I classification? - Answer-Involvement of a single
lymphatic region or localized involvement of a single extralymphatic organ or site
What defines the Ann Arbor Stage II classification? - Answer-Involvement of two or
more lymphatic regions on the same side of the diaphragm or localized involvement of a
single extralymphatic organ or site and one or more lymphatic regions on the same side
of the diaphragm
What defines the Ann Arbor Stage III classification? - Answer-Involvement of lymphatic
regions on both sides of the diaphragm
What percentage of non-Hodgkin lymphoma series does DLBCL constitute? - Answer-
30%-58%
What is the crude incidence of DLBCL in Europe? - Answer-3.8/100,000/year
What increases the risk of DLBCL? - Answer-Family history of lymphoma, autoimmune
disease, HIV infection, HCV seropositivity, high body mass as a young adult, some
occupational exposures
What type of biopsy remains the optimal method of diagnosis for DLBCL? - Answer-
Surgical excision biopsy
What should be avoided as the sole basis for diagnosing DLBCL? - Answer-Fine-needle
aspirate
What must confirm a morphological diagnosis of DLBCL? - Answer-Immunophenotypic
investigations
What should be considered if there is doubt in the diagnosis of DLBCL? - Answer-
Demonstration of B-cell monoclonality by a PCR-based method
What is the recommended gold standard for staging DLBCL patients? - Answer-FDG-
PET/CT scan
