SEOM clinical guidelines for the treatment of XXXX .

@entity1 @entity706 @entity3012 @entity5 @entity146 @entity1893
@entity1893 ( @entity1893 ) is a nodal B lymphoid malignancy that originates from the germinal center of a lymph node. @entity1893 is the second most frequent @entity706 subtype. The course of the disease is usually characterised by a typically indolent clinical course, with a median survival rate of 8-10 years, although most @entity1 relapse after treatment. Diagnosis should always be based on a surgical specimen like an excisional node lymph biopsy. The first-line treatment of @entity1893 will depend of extension disease, @entity5 burden, @entity1 symptoms, performance status and also @entity1 decision. The addition of rituximab to conventional chemotherapy has improved ORR, PFS and @entity3012 . As first line in @entity1 that need treatment, a combination of chemotherapy with rituximab induction followed by 2 years of rituximab maintenance is the best option. High-dose chemotherapy with autologous stem-cell transplantation in first line has not shown improvement and is not recommended as first-line therapy. Before any treatment decision in relapsed @entity1 , a repeat biopsy is mandatory to rule out a transformation into large cell @entity146 . Standard treatment is controversial, depends on the efficacy of prior treatment, duration of the time-to-relapse, @entity1 's age and histological findings at relapse.
