The European Hematology Association (EHA) has published two new sets of clinical practice guidelines, including its first dedicated guidelines for large B-cell lymphoma (LBCL), which was published in HemaSphere, as well as an updated set of guidelines in collaboration with the European Myeloma Network (EMN) for multiple myeloma, which was published in Nature Reviews Clinical Oncology.
“These new guidelines reflect EHA’s strong commitment to delivering timely, evidence-based resources on clinically complex conditions and emerging therapies,” said Konstanze Döhner, MD, President of the EHA. “They are intended to guide physicians in daily practice and to improve both patient outcomes and quality of life.”
Creating the Guidelines
Both evidence- and consensus-based guidelines were created by a panel of leading multidisciplinary experts and patient representatives to incorporate both sound science and clinically relevant data, and to also focus on patient outcomes and quality of life.
“Our guidelines truly embody EHA’s mission: to empower hematology professionals with the knowledge and tools they need to transform patient care,” Dr. Döhner added. “Looking ahead to 2026, we remain committed to expand this portfolio further, strengthen educational support, and continue driving innovation across the field of hematology.”
LBCL Guidelines
EHA's guidelines for LBCL, written by Catherine Thieblemont, MD, PhD, and colleagues, address the diagnosis and treatment of patients with this common form of aggressive lymphoma and highlight the importance of following up with patients. The guidelines underscore the critical role of positron-emission tomography–computed tomography (PET-CT) imaging in defining patients' risk and prognosis as well as in disease staging. PET-CT can also be used to guide treatment decision-making and assess treatment response. For example, management of patients with LBCL in the first-line setting can be impacted by interim PET to determine chemosensitivity to inform further treatment options.
The guidelines also focus on tailored approaches for specific patient populations, such as geriatric assessments and R-miniCHOP or non-anthracycline–based treatments for elderly patients, and supportive treatments plus prephase corticosteroids for frail patients.
For relapsed or refractory disease, the guidelines recommend the use of newer treatments such as chimeric antigen receptor T-cell therapies in the second-line setting and bispecific antibodies in the third-line setting.
Patients should be followed for 2 years with monitoring for long-term adverse effects, including cardiotoxicity, osteoporosis, immune dysfunction, neurocognitive impairment, endocrine dysfunction, fatigue, neuropathy, and mental distress.
Multiple Myeloma Guidelines
Updated guidelines for the diagnosis, treatment, and follow-up of patients with multiple myeloma, created in collaboration between the EHA and the EMN, incorporate the novel international staging system R2-ISS, as well as newer prognostic factors—such as minimal residual disease, circulating plasma cells, and monoclonal proteins as assessed by mass spectrometry—and 14 newer treatment regimens in the armamentarium for multiple myeloma that have been approved by the U.S. Food and Drug Administration (FDA) and/or the European Medicines Agency (EMA).
The updated set of guidelines include evidence-based algorithms for clinical practice with grades of recommendation for all newer data.
For patients with smoldering multiple myeloma specifically, newer approaches focus on determining which patients require early intervention.
The guidelines also focus on the management of myeloma-related complications and common adverse events, including bone disease, renal impairment, cytokine- release syndrome, and immune effector cell–associated neurotoxicity syndrome.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com and nature.com.
