Department of Clinical Haematology and Inserm U1245, Centre Henri Becquerel, 76038, Rouen
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin's lymphoma (NHL) in Western countries. More than half of these lymphomas can be cured with standard immunochemotherapy treatment. About 30 to 40% are refractory or relapse, suggesting a high level of underlying biological heterogeneity. Elucidation of the expression profiles have made it possible to understand this heterogeneity by defining germinal centre B-cell-like (GCB) and activated B-cell-like (ABC) subtypes. However, 20 years later, the differentiation of these subtypes remains challenging for clinicians, since therapeutic trials to improve R-CHOP efficacy by targeting more specific alterations of the ABC subtype have all been negative to date. New classifications integrating molecular data are proposed to enrich our understanding of the heterogeneity of DLBCLs and high-grade lymphomas. They may form the basis of new approaches to stratify patients and establish therapeutic strategies.