Background: non Hodgkin Lymphoma is the most common hematologic malignancy and it is the 6^th leading cause of cancer death. Relapses still occur in the majority of patients; overall, more than 30% of DLBCL will ultimately relapse. Aim of study: primary objective was to retrospectively correlate the occurrence of relapsed, refractory and in remission diffused large B cell lymphoma patients to both clinic-pathological features of the disease and line of treatment received. Patients and Method: a total of 116 patients with aggressive high grade NHL patients (DLBCL) representing 86.6% of all patients presented to Clinical Oncology Department, Ain Shams University in the period between January 2009 and December 2015. Data were collected between January 2017 until Marsh 2017. Results: the mean age at diagnosis of the studied patients was 45 years. The incidence in male was higher than female (52.6% vs. 47.4%), the majority of the cases didn't have B symptoms (57.7%), high LDH level was measured among the cases (37%)and in only 36 patient's files,16.37% of the cases had positive HCV.The most common stage at diagnosis was stage IV (33.6%)followed by stage III (29.3%).                                                              Based on response to the 1^st line chemotherapy, DLBCL patients were further statistically analyzed into three categories:24 refractory patients (20.07%), 43 relapsed patients (37.1%) and 49 patients in remission (non relapsed) (42.2%). Regarding 1^st line treatment regimen by R-Chop, complete response rates were significantly higher in patients who received R-CHOP than in the group who received CHOP alone (57.1% vs 42.8%). The median disease freesurvival in the relapsed groupwas 8 months. The median survival time for the DLBCL patients was 24 months. The survival rate after 1 year was 83.7%, while after 2 years it was 52.8% and after 3 years it was 21.3%.
Conclusion: relapsed and refractory disease continues to represent the most significant challenge in treating NHL, the addition of rituximab to the CHOP regimen increased the CR rate and prolonged event-free and overall survival.