Abstract: Primary mediastinal B-cell lymphoma (PMBCL) is aggressive Bcell lymphoma with unique clinicopathologic characteristics. However, under the new classification of PMBCL, whether R-CHOP was the standard first-line immunotherapy regimen remains a controversy. The DA-EPOCH-R is not inferior to R-CHOP, but attention should be paid to the toxic effects. PMBCL is a radiosensitive disease, but radiotherapy did not as the front-line therapy for PMBCL. A biopsy is required for positive PET/CT after immunotherapy-chemotherapy to determine the further treatment of PMBCL. Recurrent/refractory PMBCL, with poor prognosis, salvage immunochemotherapy is often used followed by high-dose chemotherapy and autologous stem cell transplant. PD-1 overexpression is common in recurrent/refractory PMBCL, and immune checkpoint inhibitors are potential to be an important treatment option. Recently, the development of molecular medicine has provided a new basis for the selection of targets in PMBCL, however, it needs to be further confirmed by clinical trials.

Key words: Lymphoma, B-cell, Radiotherapy, Rituximab, Chemotherapy