CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2021; 42(04): 356-359
DOI: 10.1055/s-0041-1735392
Trainees’ Corner

Molecular Classification of Diffuse Large B-Cell Lymphoma

Annie Kanchan Baa
1   Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
1   Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations


Diffuse large B cell lymphoma (DLBCL) is the commonest type of non-Hodgkin lymphoma (NHL) in adults, accounting for around 30 to 35% of all NHL cases.[1] [2] With current standards of care, up to 50 to 70% of these patients can achieve a lasting remission.[1] Of the remaining patients, the relapsed/refractory cases, cure is only possible in 10%, even with further lines of therapy or stem cell transplant.[1] This heterogeneity in DLBCL’s clinical behavior reflects the underlying molecular heterogeneity of the disease. Thankfully, we are now able to understand this heterogeneity a little better and subtype DLBCL cases based on immunohistochemistry (IHC) and molecular markers, enabling us to have deeper prognostic insights and helping us to make therapeutic decisions. The various classification systems in use for DLBCL include the “cell-of-origin” (COO) classification, the comprehensive consensus clustering classification, double-hit/triple-hit lymphomas (DHL/THL), double-expressor lymphomas (DEL), and the modern classification.

Supplementary Material

Publication History

Article published online:
25 November 2021

© 2021. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

  • References

  • 1 Miao Y, Medeiros LJ, Li Y, Li J, Young KH. Genetic alterations and their clinical implications in DLBCL. Nat Rev Clin Oncol 2019; 16 (10) 634-652
  • 2 Swerdlow SH, Campo E, Pileri SA, Lee HarrisN, Stein H, Siebert R. et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127 (20) 2375-90
  • 3 Alizadeh AA, Eisen MB, Davis RE. et al Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling. Nature 2000; 403 (6769) 503-511
  • 4 Rosenwald A, Wright G, Chan WC. et al Lymphoma/Leukemia Molecular Profiling Project. The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma. N Engl J Med 2002; 346 (25) 1937-1947
  • 5 Susanibar-Adaniya S, Barta SK. 2021 Update on diffuse large B cell lymphoma: a review of current data and potential applications on risk stratification and management. Am J Hematol 2021; 96 (05) 617-629
  • 6 Meyer PN, Fu K, Greiner TC. et al Immunohistochemical methods for predicting cell of origin and survival in patients with diffuse large B-cell lymphoma treated with rituximab. J Clin Oncol 2011; 29 (02) 200-207
  • 7 Hans CP, Weisenburger DD, Greiner TC. et al Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood 2004; 103 (01) 275-282
  • 8 Scott DW, Wright GW, Williams PM. et al Determining cell-of-origin subtypes of diffuse large B-cell lymphoma using gene expression in formalin-fixed paraffin-embedded tissue. Blood 2014; 123 (08) 1214-1217
  • 9 Davies A, Cummin TE, Barrans S. et al Gene-expression profiling of bortezomib added to standard chemoimmunotherapy for diffuse large B-cell lymphoma (REMoDL-B): an open-label, randomised, phase 3 trial. Lancet Oncol 2019; 20 (05) 649-662
  • 10 Younes A, Sehn LH, Johnson P. et al PHOENIX investigators. Randomized phase III trial of ibrutinib and rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in non-germinal center B-cell diffuse large B-cell lymphoma. J Clin Oncol 2019; 37 (15) 1285-1295
  • 11 Vitolo U, Witzig TE, Gascoyne RD. et al ROBUST: First report of phase III randomized study of lenalidomide/R-CHOP (R 2 -CHOP) vs placebo/R-CHOP in previously untreated ABC-type diffuse large B-cell lymphoma. Hematol Oncol 2019; 37: 36-37
  • 12 Monti S, Savage KJ, Kutok JL. et al Molecular profiling of diffuse large B-cell lymphoma identifies robust subtypes including one characterized by host inflammatory response. Blood 2005; 105 (05) 1851-1861
  • 13 Ennishi D, Jiang A, Boyle M, Collinge B, Grande BM, Ben-Neriah S, et al. Double-Hit Gene Expression Signature Defines a Distinct Subgroup of Germinal Center B-Cell-Like Diffuse Large B-Cell Lymphoma. J Clin Oncol. 2019 Jan 20;37(3):190-201.
  • 14 Schmitz R, Wright GW, Huang DW. et al Genetics and pathogenesis of diffuse large B-cell lymphoma. N Engl J Med 2018; 378 (15) 1396-1407
  • 15 Chapuy B, Stewart C, Dunford AJ. et al Molecular subtypes of diffuse large B cell lymphoma are associated with distinct pathogenic mechanisms and outcomes. Nat Med 2018; 24 (05) 679-690
  • 16 Crombie JL, Armand P. Diffuse large B-cell lymphoma’s new genomics: the bridge and the chasm. J Clin Oncol 2020; 38 (30) 3565-3574