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The addition of the antibody rituximab to CHOP (R-CHOP) has improved the outcome of diffuse large B-cell lymphoma (DLBCL) and is the current standard of care [[1]]. On the contrary, preliminary results from a trial randomizing stage II-IV DLBCL patients to R-CHOP14 and R-CHOP14 plus additional rituximab on day 8 during the first four treatment cycles did not confirm a benefit of intensified rituximab in male patients [[12]]. Consistent with this study, a more recent Swedish study including >7000 DLBCL patients reported comparable improvements in life expectancy for male and female patients during the rituximab introduction period, although no direct comparison between male and female patients was performed [[15]]. As the survival in the general population is gender-specific (5-year OS, 94% for a female and 90% for a male Danish person aged 65 in 2010), crude OS differences between male and female patients may be sensitive to excess deaths in male patients unrelated to DLBCL. [Extracted from the article]

Future studies in this area are anticipated and will hopefully determine whether rare CD34 SP + sp stem cell clones with lymphoma mutations exists in patients with lymphoma, and whether they have an impact on clinical course and treatment response. Patients were included if they had a diagnosis of lymphoma, were intended to undergo ASCT, had a sufficient stem cell harvest and had at least one additional vial of their stem cell product available for research purposes. However, another possibility is that the methods used in this report (detection limit of VAF >2%, hence able to identify mutations in four out of a 100 CD34 SP + sp cells) are not sensitive enough to detect possible B-cell lymphoma CD34 SP + sp stem cells. [Extracted from the article]