What are the treatment recommendations for early-stage diffuse large B-cell lymphoma (DLBCL) with adverse risk factors?

Updated: Jun 12, 2019
  • Author: Francisco J Hernandez-Ilizaliturri, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

Answer

Patients with adverse risk factors present:

  • R+CHOP: Combined therapy with rituximab plus  cyclophosphamide 750 mg/m2 IV on day 1 or 3 plus  doxorubicin 50 mg/m2 IV on day 1 or 3 plus  vincristine 1.4 mg/m2 (maximum dose, 2 mg) IV on day 1 or 3 plus  prednisone 40 mg/m2 PO on days 1-5 or 3-8; every 21d for 3 cycles followed by IFRT [5] or

  • R+CHOP: Rituximab 375 mg/m2 IV on day 1 plus  cyclophosphamide 750 mg/m2 IV on day 1 or 3 plus  doxorubicin 50 mg/m2 IV on day 1 or 3 plus  vincristine 1.4 mg/m2 (maximum dose, 2 mg) IV on day 1 or 3 plus  prednisone 40 mg/m2 PO on days 1-5 or 3-8; every 21d for 6 cycles with or without IFRT [6]

  • Radiographic studies including functional imaging (eg, PET scan) to document response to treatment should be done before initiation of IFRT and/or at the end of therapy

  • Always confirm residual PET abnormalities with biopsy before modifying therapy


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