• Pier Luigi Zinzani, Paolo Corradini, Maurizio Martelli, Giorgio Minotti, Stefano Oliva, Michele Spina, Giovanni Barosi, and Sante Tura.
• Institute of Hematology "Seràgnoli", University of Bologna, Bologna, Italy.
• Eur. J. Haematol. 2016 Dec 1; 97 (6): 554-561.

ObjectivesIn this paper, we present a review of critical concepts and research perspectives and produce recommendations on the optimal use of pixantrone in non-Hodgkin lymphoma (NHL) by group discussion from an expert panel appointed by the Italian Society of Hematology and the affiliate societies, Società Italiana di Ematologia Sperimentale and Gruppo Italiano Trapianto di Midollo Osseo.MethodsRecommendations were produced using the Delphi process. Scientific evidence on pixantrone efficacy was analyzed using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology in the areas where at least one randomized trial was published. The following key issues were addressed for practical recommendations: pixantrone monotherapy in aggressive relapsed or refractory non-Hodgkin B-cell lymphomas and toxicity risk management in patients candidates to pixantrone.Results And ConclusionsAfter a balanced and value-oriented discussion, the panel agreed that the benefit/risk profile was in favor of pixantrone in the treatment of adult patients with multiply relapsed or refractory aggressive NHL B-cell lymphomas. Pixantrone was deemed to be contraindicated in patients with uncontrolled cardiovascular disease. Despite a low rate of cardiotoxicity of pixantrone reported in clinical trials, the panel recommended that all patients receiving pixantrone should undergo periodical cardiac monitoring.© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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