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Histologic Transformation
There is a ~3%/y risk of transformation from FL to DLBCL, usually characterized by rapid nodal enlargement & rising LDH, ± systemic symptoms Bx is required to diagnose transformation. PET may be useful in determining a site for bx. SUV values >10–13 suggest transformation (Ann Oncol 2009;20:508) Transformation to DLBCL in a previously untreated pt treated similar to de novo DLBCL If histologic transformation occurs after prior chemotherapy, consider consolidation w/ high dose therapy and autologous stem cell rescue in chemosensitive disease