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Editor’s note: Although immunochemo-therapy with rituximab plus CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) is the standard of care for patients with diffuse large B cell lymphoma (DLBCL), a significant proportion of patients with high-risk disease are not cured with this approach. There remains a lack of consensus as to the benefit of initial treatment intensification, particularly with regard to the role of high-dose therapy and autologous stem cell transplantation (ASCT) in first response.