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Six cycles of immunochemotherapy over about four months, a PET scan to confirm the lymphoma has gone, then two years of close follow-up; if it comes back early, CAR-T cell therapy is the next step.
Typical sequence for Advanced stage (III-IV), first line disease; durations are protocol values (cycle counts and lengths, fraction schedules, guideline follow-up intervals), not averages of real patients. Your team's plan will differ in detail.
Excisional or core biopsy with immunohistochemistry and FISH (MYC, BCL2, BCL6), PET-CT, bloods; cell-of-origin and double-hit status change the plan.
SourceSix 3-week cycles of rituximab with cyclophosphamide, doxorubicin, prednisolone and either vincristine (R-CHOP) or polatuzumab vedotin (pola-R-CHP, POLARIX).
PET-CT 6-8 weeks after the last cycle; a complete metabolic response (Deauville 1-3) ends treatment.
SourceVisits every 3 months for 2 years, then every 6 months to 5 years; no routine scans after remission is confirmed.
SourceAxicabtagene ciloleucel beat salvage chemotherapy and transplant in ZUMA-7: apheresis, 3-4 weeks of manufacturing (bridging therapy if needed), 3 days of lymphodepleting chemotherapy, infusion, then about 4 weeks of monitoring for cytokine release syndrome and neurotoxicity.
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