未另行明确的弥漫性大 B 细胞淋巴瘤 (DLBCL) 是大 B 细胞淋巴瘤组中最常见的亚型，其预后存在差异，反映了病理、分子和临床特征的异质性。目前的治疗标准是基于多药化疗，包括蒽环类药物和单克隆抗CD20抗体，这使得60%的患者得到治愈。近年来，人们对淋巴瘤生物学有了新的认识，并有助于细化危险人群。这些研究的结果启发了采用靶向治疗和适应反应策略的新临床试验的设计，并允许识别可能从新药物中受益的患者群体。本综述将总结在一线环境中利用诊断时和治疗期间评估的临床和生物学预后因素来识别高危 DLBCL 患者的最新进展，还将讨论应用靶向药物和免疫疗法的新治疗策略，包括缓解- 适应策略。版权所有 © 2023 美国血液学会。

Diffuse large B-cell lymphoma (DLBCL) not otherwise specified is the most common subtype of large B-cell lymphoma group, with differences in prognosis, reflecting heterogeneity in pathological, molecular, and clinical features. Current treatment standard is based on multiagent chemotherapy including anthracycline and monoclonal antiCD20 antibody, which leads to cure of 60% patients. Recent years have brought new insights to the lymphoma biology and helped to refine risk groups. Results of these studies inspired design of new clinical trials with targeted therapies and response-adapted strategies and allowed to identify groups of patients potentially benefiting from new agents. This review will summarize recent progress in identifying high-risk DLBCL patients with employment of clinical and biological prognostic factors assessed at diagnosis and during treatment in the front line setting It will also discuss new treatment strategies with the application of targeted agents and immunotherapy, including response-adapted strategies.Copyright © 2023 American Society of Hematology.