Main therapeutic interventions in the management of patients with non-Hodgkin's lymphoma




Lymphoma, non-Hodgkin; Chemotherapy; Recurrence.


Objective: to identify the main therapeutic interventions in the management of patients with non-Hodgkin's lymphoma. Material and methods: In order to answer the research question “What are the main therapeutic interventions in the management of patients with non-Hodgkin's lymphoma?”, a systematic review of the literature was chosen. The research will be carried out through a search, based on a search strategy, in the Medical Publisher (PUBMED) and Science Direct databases, with the objective of selecting articles related to therapeutic interventions in the management of patients with non-invasive lymphoma. -Hodgkin. Results: the association of rituximab with chemotherapy and with lenalidomide may allow prolonged responses in some patients and represents an effective therapeutic option. The high-dose chemotherapy strategy with autologous stem cell transplantation has been shown to be viable and highly effective in patients with primary central nervous system lymphoma, providing a better prognosis for patients. Final considerations: it is possible to state that the therapy of choice initially for the management of patients with non-Hodgkin's lymphoma still continues to be the association of rituximab with chemotherapy in the R-CHOP regimen, with the possibility of still being associated with lenalidomide, allowing answers prolonged in some patients and representing an effective therapeutic option. Maintenance therapy with rituximab has been shown to improve progression-free survival in patients with follicular lymphoma, improving survival rates and the duration of disease remission. Combined modality therapy (chemotherapy + immunotherapy) may have better outcomes and prognosis for patients with diffuse large B-cell lymphoma.


Beylot-Barry, M., Mermin, D., Maillard, A., Bouabdallah, R., Bonnet, N., Duval-Modeste, A. B., Mortier, L., Ingen-Housz-Oro, S., Ram-Wolff, C., Barete, S., Dalle, S., Maubec, E., Quereux, G., Templier, I., Bagot, M., Grange, F., Joly, P., Vergier, B., Vially, P. J., Gros, A., & Merlio, J. P. (2018). A Single-Arm Phase II Trial of Lenalidomide in Relapsing or Refractory Primary Cutaneous Large B-Cell Lymphoma, Leg Type. The Journal of investigative dermatology, 138(9), 1982–1989.

Brasil. (2014). Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: Sistema GRADE – Manual de graduação da qualidade da evidência e força de recomendação para tomada de decisão em saúde: Ministério da Saúde.

Bruna, R., Benedetti, F., Boccomini, C., Patti, C., Barbui, A. M., Pulsoni, A., Musso, M., Liberati, A. M., Gini, G., Castellino, C., Rossini, F., Ciceri, F., Rota-Scalabrini, D., Stelitano, C., Di Raimondo, F., Tucci, A., Devizzi, L., Zoli, V., Zallio, F., Narni, F., & Tarella, C. (2019). Prolonged survival in the absence of disease-recurrence in advanced-stage follicular lymphoma following chemo-immunotherapy: 13-year update of the prospective, multicenter randomized GITMO-IIL trial. Haematologica, 104(11), 2241–2248.

Chigurupati, S. V., Shukla, M., & Pandey, M. (2021). Primary sacral non-Hodgkin's lymphoma: report of a case and systematic review of literature. World journal of surgical oncology, 19(1), 61.

Davison, K., Chen, B. E., Kukreti, V., Couban, S., Benger, A., Berinstein, N. L., Kaizer, L., Desjardins, P., Mangel, J., Zhu, L., Djurfeldt, M. S., Hay, A. E., Shepherd, L. E., & Crump, M. (2017). Treatment outcomes for older patients with relapsed/refractory aggressive lymphoma receiving salvage chemotherapy and autologous stem cell transplantation are similar to younger patients: a subgroup analysis from the phase III CCTG LY.12 trial. Annals of oncology: official journal of the European Society for Medical Oncology, 28(3), 622–627.

Donato, H., & Donato, M. (2019). Etapas na Condução de uma Revisão Sistemática. Acta Médica Portuguesa, 32(3), 227-235.

Fajardo, L., Ramin, G. de A., Penachim, T. J., Martins, D. L., Cardia, P. P., & Prando, A. (2016). Manifestações abdominais do linfoma extranodal: ensaio iconográfico. Radiologia Brasileira, 49(6), 397–402.

Gleeson, M., Counsell, N., Cunningham, D., Chadwick, N., Lawrie, A., Hawkes, E. A., McMillan, A., Ardeshna, K. M., Jack, A., Smith, P., Mouncey, P., Pocock, C., Radford, J. A., Davies, J., Turner, D., Kruger, A., Johnson, P., Gambell, J., & Linch, D. (2017). Central nervous system relapse of diffuse large B-cell lymphoma in the rituximab era: results of the UK NCRI R-CHOP-14 versus 21 trial. Annals of oncology: official journal of the European Society for Medical Oncology, 28(10), 2511–2516.

Guzauskas, G. F., Masaquel, A., Reyes, C., Bernaards, C., Krivasi, T., & Veenstra, D. L. (2018). Cost-effectiveness of obinutuzumab plus bendamustine followed by obinutuzumab monotherapy for the treatment of follicular lymphoma patients who relapse after or are refractory to a rituximab-containing regimen in the US. Journal of medical economics, 21(10), 960–967.

Hu, X., Zeng, M., Yang, S. E., Liang, X., Ding, S. S., Guo, L., Li, S., & Wen, S. J. (2017). Efficacy of rituximab combined with CHOP for treating patients with diffuse large B-cell lymphoma. Medicine, 96(45), e8494.

Illerhaus, G., Schorb, E., & Kasenda, B. (2018). Novel agents for primary central nervous system lymphoma: evidence and perspectives. Blood, 132(7), 681–688.

Iqbal, M., Reljic, T., Ayala, E., Sher, T., Murthy, H., Roy, V., Foran, J., Tun, H., Kumar, A., & Kharfan-Dabaja, M. A. (2020). Efficacy of Allogeneic Hematopoietic Cell Transplantation in Cutaneous T Cell Lymphoma: Results of a Systematic Review and Meta-Analysis. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 26(1), 76–82.

Kuruvilla, J., MacDonald, D. A., Kouroukis, C. T., Cheung, M., Olney, H. J., Turner, A. R., Anglin, P., Seftel, M., Ismail, W. S., Luminari, S., Couban, S., Baetz, T., Meyer, R. M., Hay, A. E., Shepherd, L., Djurfeldt, M. S., Alamoudi, S., Chen, B. E., & Crump, M. (2015). Salvage chemotherapy and autologous stem cell transplantation for transformed indolent lymphoma: a subset analysis of NCIC CTG LY12. Blood, 126(6), 733–738.

Leonard, J. P., Jung, S. H., Johnson, J., Pitcher, B. N., Bartlett, N. L., Blum, K. A., Czuczman, M., Giguere, J. K., & Cheson, B. D. (2015). Randomized Trial of Lenalidomide Alone Versus Lenalidomide Plus Rituximab in Patients With Recurrent Follicular Lymphoma: CALGB 50401 (Alliance). Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 33(31), 3635–3640.

Lopez-Santillan, M., Lopez-Lopez, E., Alvarez-Gonzalez, P., Martinez, G., Arzuaga-Mendez, J., Ruiz-Diaz, I., Guerra-Merino, I., Gutierrez-Camino, A., & Martin-Guerrero, I. (2021). Prognostic and therapeutic value of somatic mutations in diffuse large B-cell lymphoma: A systematic review. Critical reviews in oncology/hematology, 165, 103430.

Oliveira, L. S., Cruz, J. A. L., Rockenbach, M., & Dobrachinski, L. (2021). Aspectos clínicos e histopatológicos dos linfomas Hodking e não Hodking: uma revisão sistemática / Clinical and histopathological aspects of Hodking and non-Hodking lymphomas: a systematic review. Brazilian Journal of Development, 7(2), 15808–15815.

Parrott, M., Rule, S., Kelleher, M., & Wilson, J. (2018). A Systematic Review of Treatments of Relapsed/Refractory Mantle Cell Lymphoma. Clinical lymphoma, myeloma & leukemia, 18(1), 13–25.e6.

Peng, Y. Y., Xiong, Y. Y., Zhang, L. X., Wang, J., Zhang, H. B., Xiao, Q., & Guo, S. L. (2021). Allogeneic Hematopoietic Stem Cell Transplantation in Extranodal Natural Killer/T-cell Lymphoma. Turkish journal of haematology : official journal of Turkish Society of Haematology, 38(2), 126–137.

Prisma Group. (2015). Preferred Reporting Items for Systematic Reviews and Meta-Analyses. University of Ottawa/Oxford University.

Schorb, E., Finke, J., Ferreri, A. J., Ihorst, G., Mikesch, K., Kasenda, B., Fritsch, K., Fricker, H., Burger, E., Grishina, O., Valk, E., Zucca, E., & Illerhaus, G. (2016). High-dose chemotherapy and autologous stem cell transplant compared with conventional chemotherapy for consolidation in newly diagnosed primary CNS lymphoma--a randomized phase III trial (MATRix). BMC cancer, 16, 282.

Srour, S. A., Li, S., Popat, U. R., Qazilbash, M. H., Lozano-Cerrada, S., Maadani, F., Alousi, A., Kebriaei, P., Anderlini, P., Nieto, Y., Jones, R., Shpall, E., Champlin, R. E., & Hosing, C. (2017). A randomized phase II study of standard-dose versus high-dose rituximab with BEAM in autologous stem cell transplantation for relapsed aggressive B-cell non-hodgkin lymphomas: long term results. British journal of haematology, 178(4), 561–570.

Stephens, D. M., Li, H., LeBlanc, M. L., Puvvada, S. D., Persky, D., Friedberg, J. W., & Smith, S. M. (2016). Continued Risk of Relapse Independent of Treatment Modality in Limited-Stage Diffuse Large B-Cell Lymphoma: Final and Long-Term Analysis of Southwest Oncology Group Study S8736. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 34(25), 2997–3004.

Taverna, C., Martinelli, G., Hitz, F., Mingrone, W., Pabst, T., Cevreska, L., Del Giglio, A., Vanazzi, A., Laszlo, D., Raats, J., Rauch, D., Vorobiof, D. A., Lohri, A., Biaggi Rudolf, C., Rondeau, S., Rusterholz, C., Heijnen, I. A., Zucca, E., & Ghielmini, M. (2016). Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 34(5), 495–500.

Yang, Y. T., Tai, C. J., Chen, C., Wu, H. C., Mikhaylichenko, N., Chiu, H. T., Chen, Y. Y., & Hsu, Y. E. (2016). Highly Diverse Efficacy of Salvage Treatment Regimens for Relapsed or Refractory Peripheral T-Cell Lymphoma: A Systematic Review. PloS one, 11(10), e0161811.

Ying, Z., Yang, H., Guo, Y., Li, W., Zou, D., Zhou, D., Wang, Z., Zhang, M., Wu, J., Liu, H., Zhang, P., Yang, S., Zhou, Z., Zheng, H., Song, Y., & Zhu, J. (2021). Relmacabtagene autoleucel (relma-cel) CD19 CAR-T therapy for adults with heavily pretreated relapsed/refractory large B-cell lymphoma in China. Cancer medicine, 10(3), 999–1011.

Zinzani, P. L., Flinn, I. W., Yuen, S., Topp, M. S., Rusconi, C., Fleury, I., Le Dû, K., Arthur, C., Pro, B., Gritti, G., Crump, M., Petrich, A., Samineni, D., Sinha, A., Punnoose, E. A., Szafer-Glusman, E., Spielewoy, N., Mobasher, M., Humphrey, K., Kornacker, M., & Hiddemann, W. (2020). Venetoclax-rituximab with or without bendamustine vs bendamustine-rituximab in relapsed/refractory follicular lymphoma. Blood, 136(23), 2628–2637.



How to Cite

COELHO, B. A. R.; MORAIS, A. M. B. de . Main therapeutic interventions in the management of patients with non-Hodgkin’s lymphoma. Research, Society and Development, [S. l.], v. 11, n. 14, p. e493111436400, 2022. DOI: 10.33448/rsd-v11i14.36400. Disponível em: Acesso em: 9 dec. 2023.



Health Sciences