DLBCL ESMO Guideline Exam Questions with Answers
/.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
/.What staging classification system is used for DLBCL? - Answer-✅Ann Arbor
classification system
/.What should be calculated for prognostic purposes in DLBCL? - Answer-
✅International Prognostic Index (IPI) and age-adjusted IPI (aa-IPI)
/.What treatment strategy is the current standard for young low-risk DLBCL patients
without bulky disease? - Answer-✅Six cycles of R-CHOP21
/.What is the recommended treatment for elderly DLBCL patients aged >80 years? -
Answer-✅R-miniCHOP
/.What is recommended for patients with high-intermediate-risk and high-risk IPI in
DLBCL? - Answer-✅CNS prophylaxis
, /.What should HIV-positive DLBCL patients receive in addition to antiviral therapy? -
Answer-✅Same treatment as HIV-negative patients
/.What is the recommended standard for post-treatment assessment in DLBCL? -
Answer-✅FDG-PET/CT
/.What percentage of DLBCL cases ultimately relapse? - Answer-✅More than 30%
/.What is a common salvage regimen for relapsed DLBCL? - Answer-✅R-DHAP or R-
ICE
/.What type of transplantation may be considered for patients with refractory disease,
early relapse, or relapse after ASCT? - Answer-✅Allogeneic transplantation
/.What is the molecular subtype of DLBCL associated with a worse prognosis when
treated with R-CHOP? - Answer-✅Activated B-cell (ABC) subtype
/.Which kinase inhibitor has shown selective activity in ABC-DLBCL? - Answer-
✅Ibrutinib
/.What is the standard treatment for DLBCL in patients aged 60-80 years? - Answer-
✅Six to eight cycles of R-CHOP21
/.What is the main therapeutic concern for patients with cardiac dysfunction or who are
frail or unfit? - Answer-✅Substitution or omission of doxorubicin
/.What is the predictive value of early PET evaluation in DLBCL treatment? - Answer-
✅Predictive of outcome, reserved for clinical trials
/.What type of assessment is crucial in guiding treatment choices for elderly DLBCL
patients? - Answer-✅Comprehensive geriatric assessment
/.What condition increases the risk of CNS relapse in DLBCL patients? - Answer-✅MYC
gene rearrangement
/.What is a common first-line treatment approach for relapsed DLBCL? - Answer-
✅Salvage chemotherapy followed by ASCT
/.What type of molecular defect might be useful in future DLBCL treatment? - Answer-
✅Frequent and recurrent mutations identified by whole-genome sequencing
/.What is the role of interim PET in DLBCL treatment? - Answer-✅Evaluating patients
who might benefit from consolidative ASCT or radiotherapy
/.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
/.What staging classification system is used for DLBCL? - Answer-✅Ann Arbor
classification system
/.What should be calculated for prognostic purposes in DLBCL? - Answer-
✅International Prognostic Index (IPI) and age-adjusted IPI (aa-IPI)
/.What treatment strategy is the current standard for young low-risk DLBCL patients
without bulky disease? - Answer-✅Six cycles of R-CHOP21
/.What is the recommended treatment for elderly DLBCL patients aged >80 years? -
Answer-✅R-miniCHOP
/.What is recommended for patients with high-intermediate-risk and high-risk IPI in
DLBCL? - Answer-✅CNS prophylaxis
, /.What should HIV-positive DLBCL patients receive in addition to antiviral therapy? -
Answer-✅Same treatment as HIV-negative patients
/.What is the recommended standard for post-treatment assessment in DLBCL? -
Answer-✅FDG-PET/CT
/.What percentage of DLBCL cases ultimately relapse? - Answer-✅More than 30%
/.What is a common salvage regimen for relapsed DLBCL? - Answer-✅R-DHAP or R-
ICE
/.What type of transplantation may be considered for patients with refractory disease,
early relapse, or relapse after ASCT? - Answer-✅Allogeneic transplantation
/.What is the molecular subtype of DLBCL associated with a worse prognosis when
treated with R-CHOP? - Answer-✅Activated B-cell (ABC) subtype
/.Which kinase inhibitor has shown selective activity in ABC-DLBCL? - Answer-
✅Ibrutinib
/.What is the standard treatment for DLBCL in patients aged 60-80 years? - Answer-
✅Six to eight cycles of R-CHOP21
/.What is the main therapeutic concern for patients with cardiac dysfunction or who are
frail or unfit? - Answer-✅Substitution or omission of doxorubicin
/.What is the predictive value of early PET evaluation in DLBCL treatment? - Answer-
✅Predictive of outcome, reserved for clinical trials
/.What type of assessment is crucial in guiding treatment choices for elderly DLBCL
patients? - Answer-✅Comprehensive geriatric assessment
/.What condition increases the risk of CNS relapse in DLBCL patients? - Answer-✅MYC
gene rearrangement
/.What is a common first-line treatment approach for relapsed DLBCL? - Answer-
✅Salvage chemotherapy followed by ASCT
/.What type of molecular defect might be useful in future DLBCL treatment? - Answer-
✅Frequent and recurrent mutations identified by whole-genome sequencing
/.What is the role of interim PET in DLBCL treatment? - Answer-✅Evaluating patients
who might benefit from consolidative ASCT or radiotherapy
