Current diagnostics and therapy of B cell Non Hodgkin Lymphoma

New diagnostic tools and therapeutic options for Non Hodgkin Lymphoma (NHL) contributed to several improvements in the understanding and treatment of this hematological malignancies. In diffuse large cell lymphoma (DLBCL) gene expression profiling and molecular analyses of myc and bcl-2 gene rearrangements resulted in the description of new DLBCL entities with significant differences in outcome. Combination immunochemotherapy according to the R-CHOP protocol remains the mainstay for treatment of DLBCL in younger and older patients. Mantle cell lymphoma is characterised by the overexpression of cyclin D1. While older patients should be treated with R-CHOP with rituximab maintenance therapy, first line treatment of younger patients should also include AraC containing regimens and autologous stem cell transplantation. Cases with follicular lymphoma very often show the t(14; 18) translocation resulting in overexpression of BCL2 and diminished apoptosis. Compared to R-CHOP treatment new combinations with R-Bendamustin have shown high efficacy with reduced toxicity and should therefore be regarded as standard in patients in need for therapy.