Advanced diffuse large B-cell non-Hodgkin lymphoma – an atypical clinical case, refractory disease and therapeutic challenges in current practice

Diffuse large B-cell lymphoma (DLBCL) is the most common sub­type of non-Hodgkin lymphoma, and it is included in the aggressive lymphomas group. It affects males more often than women, and its incidence increases with age. Although the vast majority of patients have a good out­come and achieve complete remission after first-line treat­ment, there is a significant proportion of patients with re­frac­tory or relapsed disease, which is associated with a poor prognosis. We present the case of a patient with dif­fuse large B-cell non-Hodgkin lymphoma, germinal cen­ter phenotype (GCB-like), primarily refractory to stan­dard R-CHOP chemotherapy. Although multiple lines of treat­ment were subsequently administered, the disease pro­gressed without remission, highlighting the challenges of ma­na­ging refractory DLBCL. We discuss the clinical course, em­pha­size the lack of response to treatment, and we review the current therapeutic options in refractory diffuse large B-cell lymphoma, including novel therapies such as CAR-T and other targeted agents, as well as their potential to achieve remission.