What chemotherapy regimen would you offer to a patient with DLBCL who was originally diagnosed and treated (R-CHOP) 15 years ago, now with a 2nd primary/late recurrence of DLBCL?  

Interesting question - the optimal approach to late-relapsing DLBCL in the modern era is not well defined. Often we will work to clarify if the late relapse is indeed a late relapse as opposed to a second primary - clonality studies on the new and prior lymphoma can be informative in some cases. If ...