Primary mediastinal B-cell lymphoma (PMBCL) is a distinct clinicopathological entity within the spectrum of aggressive B-cell lymphomas, characterised by unique clinical, immunophenotypic and molecular features.
Since publication of the 2019 British Society for Haematology (BSH) Good Practice Paper, there have been important advances in imaging, radiotherapy approaches and systemic therapies, including chimeric antigen receptor (CAR) T-cell therapy and immune checkpoint inhibition. Key updates include the use of PET-adapted approaches to guide radiotherapy decisions following first-line chemoimmunotherapy, with omission of consolidative radiotherapy in patients achieving complete metabolic response.
The guideline emphasises the importance of dose-intensive chemoimmunotherapy regimens and provides a framework for the clinical management of patients with Deauville stage 4 (DS4) and DS5 response status on PET-CT imaging following chemoimmunotherapy.
Declaration of Interests
The BSH paid the expenses incurred during the writing of this good practice paper. All authors have made a declaration of interests to the BSH and Task Force Chairs which may be viewed on request.