Updates to the NCCN's Guidelines for Non-Hodgkin's Lymphoma

Updates and recommendations have been made to the National Comprehensive Cancer Network's (NCCN) Clinical Practice Guidelines in Oncology. These updates were presented at the recent NCCN Annual Conference. The most important updates are outlined below regarding non-Hodgkin's lymphoma by Steven M. Horowitz MD, of Memorial Sloan Kettering Cancer Center by way of Onclive.

Chronic Lymphocytic Leukemia: For patients with previously untreated chronic lymphocytic leukemia (CLL), obinutuzumab (Gazyva) plus chlorambucil has been added as a therapy option for patients without an 11q or 17p deletion who might be "frail with significant comorbidities, and both older and younger patients either with or without comorbidities."

Chronic Lymphocytic Leukemia: Imbruvica (ibrutinib) has also been added as a therapy option for patients with CLL without an 11q or 17p deletion who have received at least one prior therapy.

Diffuse Large B-cell Lymphoma (DLBCL): Recommended follow-up imaging post-treatment has been changed from CT scans every 6 months to 2 years to "only as clinically needed."

Follicular Lymphoma: The NCCN now recommends PET-CT scans for evaluation at presentation and following initial response to front-line therapy.

Perhaps most interestingly, a pair of new guidelines for rare lymphomas have been added. The new guidelines are characterized as "largely educational to define these diseases and help clinicians accurately recognize and distinguish [them] from other types of lymphomas", and they are for:

• Primary Cutaneous CD30+ T-Cell Lymphoproliferative Disorder
• T-Cell Large Granular Lymphocyte Leukemia

Source: OncLive