Which chemotherapy regimens are used in the treatment of diffuse large cell lymphoma?

Updated: Jun 12, 2019
  • Author: Shipra Gandhi, MBBS; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Chemotherapeutic regimens used in the treatment of diffuse large cell lymphoma include the following:

  • CHOP: Cyclophosphamide, doxorubicin (Adriamycin), vincristine, and prednisone; standard treatment for early-stage diffuse large cell lymphoma; current data suggest that either 6 cycles of CHOP or 3-4 cycles of CHOP followed by involved-field radiation therapy (IFRT) is reasonable treatment for early-stage, nonbulky diffuse large cell lymphoma (stage IA or IIA, nonbulky)

  • R-CHOP: Rituximab plus CHOP; standard therapy for patients with advanced diffuse large cell lymphoma

  • Dose-adjusted EPOCH (etoposide, prednisone, vincristine [Oncovin], cyclophosphamide, doxorubicin) , plus rituximab [2]

Salvage chemotherapeutic regimens used in relapse therapy include the following:

  • DHAP - Dexamethasone, high-dose cytarabine, and cisplatin

  • ESHAP - Etoposide, methylprednisolone, high-dose cytarabine, and cisplatin

  • MIME - Mesna, ifosfamide, methotrexate, and etoposide

  • IMVP-16 - Ifosfamide, methotrexate, and etoposide

After the first relapse, however, the duration of the second complete response to treatment is frequently shorter than 1 year. Patients whose condition relapses and who have chemoresponsive disease, as evaluated after salvage therapy, should be considered for high-dose chemotherapy followed by stem cell rescue.

See Treatment and Medication for more detail.


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