Frontiers in oncology · 2025
Diagnostic and therapeutic pathways for lymphoma patients: expert consensus through Nominal Group Technique and Delphi methodology.
СтатьяНазвание и аннотация: Перевод в очереди
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Guarini Attilio, Bozzoli Valentina, Ciavarella Sabino, Cimminiello Michele, Donatelli Francesca, Fama Angelo, Fesce Vincenza Fernanda, Fraticelli Vincenzo, Gaudio Francesco, Greco Giuseppina, Augusto Martellini, Merchionne Francesca, Miccolis Rosanna Maria, Minoia Carla, Pennese Elsa, Perrone Tommasina, Scalzulli Potito Rosario, Scattone Anna, Skrypets Tetiana, Specchia Mariarosaria, Tonialini Lorenzo, Valvano Mariarosaria, Pavone Vincenzo
Аннотация
INTRODUCTION: Lymphomas encompass a heterogeneous group of B- and T-cell malignancies necessitating a complex and precise management. With the aim to define standardized diagnostic and therapeutic pathways across multiple hematology centers in Italy, the "Right Path 4 Lymphomas" project was designed as a multidisciplinary expert platform designed to establish consensus-driven diagnostic and therapeutic pathways.
METHODS: Using a two-phase methodology - the Nominal Group Technique followed by a Delphi process - experts systematically evaluated and prioritized key diagnostic and therapeutic topics for five major lymphoma subtypes: classical Hodgkin lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, and peripheral T-cell lymphomas.
RESULTS: The Delphi process achieved a high level of consensus on 264 of 270 statements (97.8%), reinforcing the importance of multidisciplinary collaboration in shaping evidence-based recommendations. Key areas of agreement included histopathologic and molecular diagnostic standards, risk-adapted treatment approaches integrating novel immunotherapies, and structured follow-up strategies. However, areas of debate remained over the clinical utility of minimal residual disease monitoring, optimal sequencing of immunotherapies, and the potential of CAR-T therapy versus bispecific antibodies.
DISCUSSION: This project highlights the need for a structured, consensus-driven approach to lymphoma care that aligns with evolving international guidelines while addressing the distinct regulatory and healthcare landscape in Italy. The findings provide a valuable framework for clinicians and policymakers to optimize lymphoma management, balancing innovation with the allocation of resources and clinical feasibility.
METHODS: Using a two-phase methodology - the Nominal Group Technique followed by a Delphi process - experts systematically evaluated and prioritized key diagnostic and therapeutic topics for five major lymphoma subtypes: classical Hodgkin lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, and peripheral T-cell lymphomas.
RESULTS: The Delphi process achieved a high level of consensus on 264 of 270 statements (97.8%), reinforcing the importance of multidisciplinary collaboration in shaping evidence-based recommendations. Key areas of agreement included histopathologic and molecular diagnostic standards, risk-adapted treatment approaches integrating novel immunotherapies, and structured follow-up strategies. However, areas of debate remained over the clinical utility of minimal residual disease monitoring, optimal sequencing of immunotherapies, and the potential of CAR-T therapy versus bispecific antibodies.
DISCUSSION: This project highlights the need for a structured, consensus-driven approach to lymphoma care that aligns with evolving international guidelines while addressing the distinct regulatory and healthcare landscape in Italy. The findings provide a valuable framework for clinicians and policymakers to optimize lymphoma management, balancing innovation with the allocation of resources and clinical feasibility.