Diagnostic and therapeutic pathways for lymphoma patients: expert consensus through Nominal Group Technique and Delphi methodology
Year: 2025
Type: article
Abstract: 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.
Source: Frontiers in Oncology
Authors: Attilio Guarini, Valentina Bozzoli, Sabino Ciavarella, Michele Cimminiello, Francesca Donatelli, Angelo Fama, Vincenza Fernanda Fesce, Vincenzo Fraticelli, Francesco Gaudio, Giuseppina Greco, Augusto Martellini, Francesca Merchionne, Rosanna Maria Miccolis, Carla Minoia, Elsa Pennese, Tommasina Perrone, Potito Rosario Scalzulli, Anna Scattone, Tetiana Skrypets, Mariarosaria Specchia, Lorenzo Tonialini, Mariarosaria Valvano, Vincenzo Pavone
Institutions: Istituto Tumori Bari, Ospedale Vito Fazzi, Ospedale San Carlo, Pia Fondazione di Culto e Religione Azienda Ospedaliera "Card. G. Panico", University of Foggia, Ospedali Riuniti di Foggia, University of Bari Aldo Moro, Ospedale A. Perrino, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, Casa Sollievo della Sofferenza
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funder: Ministero della Salute
Award: G5343711819
OpenAlex ID: W4413178512