How is Dhap given?

The drugs are run through a pump, which gives you the chemotherapy over a set time. You have lots of drugs and fluids when you have DHAP. This means you may have two drips (infusions) running at the same time. Dexamethasone is usually given as tablets, but it may be given as a drip.

What happens to B cells in DLBCL?

B cells instead continue to develop and mature in the bone marrow and lymph nodes. In DLBCL, the abnormal B cell lymphocytes are larger than normal, and they have stopped responding to signals that usually limit the growth and reproduction of cells.

What is ABC type DLBCL?

The activated B-cell (ABC) subset of diffuse large B-cell lymphoma (DLBCL) is biologically distinct, characterized by clonic B-cell receptor signaling, and associated with poor outcomes when treated with a standard therapy. Activation of the clonic B-cell receptor pathway allows for therapeutic targeting.

How do you treat relapsed/refractory diffuse large B cell lymphoma?

Abstract. Despite progress in the upfront treatment of diffuse large B cell lymphoma (DLBCL), patients still experience relapses. Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard second-line treatment for relapsed and refractory (R/R) DLBCL.

What does DHAP mean?

Abbreviation for dihydroxyacetone phosphate.

What is DHAP biochemistry?

Dihydroxyacetone phosphate (DHAP, also glycerone phosphate in older texts) is the anion with the formula HOCH2C(O)CH2OPO32-. This anion is involved in many metabolic pathways, including the Calvin cycle in plants and glycolysis. It is the phosphate ester of dihydroxyacetone.

What percentage of DLBCL is ABC?

The International DLBCL R-CHOP Consortium performed an analysis of 893 patients with de novo DLBCL and found that 66% of DELs were ABC DLBCL, while only 39% of non-DELs were ABC DLBCL.

What percent of DLBCL patients relapse?

Background: DLBCL has a 40% relapse rate in the rituximab era. Patients who relapse within a year do poorly even with salvage treatment.

Why is DHAP converted to G3P?

DHAP is a precursor to triglycerides, and is used in their synthesis, while G3P is an intermediate in glycolysis, an ATP-producing process. In order to favor the conversion of DHAP into G3P, and not the opposite, the cell must keep G3P levels low (Le Chatelier’s Principle).

What does glycerol 3-phosphate dehydrogenase do?

Glycerol-3-phosphate dehydrogenase serves as a major link between carbohydrate metabolism and lipid metabolism. It is also a major contributor of electrons to the electron transport chain in the mitochondria.

Why is DHAP important?

The balance between DHAP and G3P is extremely important in regulating overall cell metabolism. DHAP is a precursor to triglycerides, and is used in their synthesis, while G3P is an intermediate in glycolysis, an ATP-producing process.

What is DHAP converted?

Dihydroxyacetone phosphate (DHAP) is converted to glycerol-3-phosphate (G3P) by glycerol-3-phosphate dehydrogenase (GPD1) or by glycerol-3-phosphate dehydrogenase-like (GPD1L) enzymes (Ou et al. 2006, Valdivia et al. 2009).

What is the pathophysiology of DLBCL?

DLBCL is a heterogeneous group of tumors made up of large transformed B cells with basophilic cytoplasm, prominent nucleoli, diffuse growth pattern, and a greater than 40% proliferation fraction. There is usually complete effacement of the normal lymph node architecture by sheets of atypical lymphoid cells.

What is the initial evaluation for diffuse large B-cell lymphocytic leukemia (DLBCL)?

Initial evaluation for treatment options in patients with DLBCL depends on the precise histologic subtype, the extent and sites of disease, and the performance status of the patient. Advanced disease is traditionally defined as Ann Arbor stage III or IV and accounts for approximately 70% of patients with DLBCL.

What is the role of rituximab in the treatment of DLBCL?

Rituximab in early-stage DLBCL. The use of monoclonal antibodies, particularly rituximab, has changed the treatment paradigm of patients with B-cell non-Hodgkin lymphoma, including DLBCL. Rituximab is a chimeric monoclonal antibody that targets the CD20 antigen present in normal and most of the malignant B-cells.

What are the treatment options for relapsed DLBCL?

The treatment of relapsed DLBCL is problematic because even though salvage regimens can be effective, they are often intensive, hospital-based and usually not curative by themselves. The reduction in morbidity and mortality with autologous SCT has enabled patients who are less than 75 years old who respond to salvage therapy to undergo SCT.