Diffuse large B-cell lymphoma（DLBCL）是最常见的恶性B细胞肿瘤之一，每年患病率为5.6/10万人，发病平均年龄约为65岁。它是一种侵袭性的非霍奇金淋巴瘤，需要紧急治疗以治愈。到目前为止，还没有基于证据的指南可用。为了制定这个第一个国际性证据为基础的DLBCL特定指南，进行了各种系统文献搜索。使用了5个系统评价、21个随机对照试验（RCTs）和36个非随机研究来制定42条建议。142条建议是基于专家共识制定的。所有建议均在结构化的共识发现过程中得到批准。对于诊断，应进行联合正电子发射计算机断层扫描和计算机断层扫描（PET/CT）（证据：前瞻性登记研究）。对于所有没有禁忌症的新诊断DLBCL患者，应该以治愈意图开展基于R-CHOP的免疫化疗（利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松）（证据：RCTs）。个体化的治疗策略应根据患者的年龄和风险组合进行调整。一旦免疫化疗完成，应再次进行PET/CT检查以检查是否达到缓解。对于PET阳性残留病变可以进行放射治疗的患者，应该接受巩固性放疗（证据：回顾性队列研究）。本临床实践指南关于DLBCL和相关实体的诊断、治疗和随访提供了标准化的临床管理方法，确定了需要改进的领域，并可作为进一步研究的基础。

Diffuse large B-cell lymphoma (DLBCL) is the most common malignant B-cell neoplasm, with an incidence of 5.6 per 100 000 persons per year and a mean age of onset of approximately 65 years. It is an aggressive type of non-Hodgkin's lymphoma requiring urgent treatment with curative intent. Evidence-based guidelines have not been available to date.For this first international evidence-based DLBCL-specific guideline, various systematic literature searches were performed. 5 systematic reviews, 21 randomized controlled trials (RCTs), and 36 non-randomized studies were used to formulate 42 recommendations. 142 were formulated on the basis of expert consensus. All recommendations were approved in a structured consensus-finding process.For staging, combined positron emission tomography and computed tomography (PET/CT) should be performed (evidence: a prospective registry study). For all patients with a new diagnosis of DLBCL and without contraindications, R-CHOP based immunochemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) should be initiated with curative intent (evidence: RCTs). The individual treatment strategy is tailored to the patient's age and risk constellation. Once immunochemotherapy has been completed, PET/CT should be performed again to check for remission. Patients with PETpositive residual disease that is amenable to radiotherapy should be treated with consolidating irradiation (evidence: retrospective cohort study).This clinical practice guideline on the diagnosis, treatment, and follow-up of patients with DLBCL and related entities provides a standardized clinical management approach, identifies areas where improvement would be desirable, and can serve as a basis for the development of further studies.