Diffuse large B-cell lymphoma (DLBCL) treatment and side effects

If this happens, you’ll need more treatment. There’s a range of options your medical team will discuss with you.

You’ll have a different type of chemotherapy from the one you had in your first treatment. You may have chemotherapy on its own, or you may have it along with monoclonal antibodies or other targeted therapies. This second round of chemotherapy is often called salvage therapy.

If you’re fit enough and the lymphoma responds to salvage therapy, you may be offered a stem cell transplant (see below).

Together, you and your medical team will choose a treatment plan. Possible drug treatments include:

You’ll usually go to hospital as a day patient to have treatment for relapsed or refractory DLBCL.

• Rituximab is usually given through a drip into a vein, or sometimes as an injection under the skin.
• Chemotherapy drugs (such as gemcitabine, cisplatin, oxaliplatin and bendamustine) are usually given by injection or a drip (infusion) into a vein or central line.
• Polatuzumab vedotin is given by a drip into a vein.

The aim of a stem cell transplant is to rebuild your immune system after high doses of chemotherapy.

For some people, a stem cell transplant using your own healthy stem cells (an autologous stem cell transplant) might be an option.

You’ll only be offered a stem cell transplant if your doctors think you’re fit enough, and you have relapsed or refractory DLBCL that has responded to a second round of chemotherapy. This is because a stem cell transplant will only work if your body has responded well to chemotherapy before.

Your consultant will discuss this with you in detail if a transplant is a good option for you.

For more information on stem cell transplants, order or download our booklet Blood stem cell and bone marrow transplants: The seven steps.

The African Caribbean Leukaemia Trust (ACLT) are a charity dedicated to getting more donors on the stem cell register. They also support people and families before and after a donor stem cell transplant.

Researchers in the UK and abroad have developed a new type of treatment called CAR-T therapy, which is currently available to people in the UK with relapsed or refractory DLBCL who haven’t responded to two or more previous treatments and are considered appropriate for CAR-T therapy.

Speak to your healthcare team if you want to find out more about this treatment.

You can also read our information about CAR-T therapy.

Occasionally, treatment is unsuccessful. Palliative care is used when no further treatment options are available to cure or control the cancer.

Palliative care involves a range of health professionals working together to give people relief from their symptoms, including pain and distress. It includes physical, psychological, emotional, social and spiritual support for both the person with lymphoma and their family.

If you have relapsed or refractory DLBCL, your doctor may be ask you to consider taking part in a clinical trial, if there’s a suitable one available.

Taking part in a clinical trial has many advantages, including the opportunity to try a new treatment that may benefit you, or others like you, in the future.

Find out more about clinical trials.