Safety and efficacy of a pre-phase with dexamethasone followed by fractionated R-CHOP in diffuse large B-cell lymphoma patients with gastrointestinal involvement at diagnosis.
[BACKGROUND] Standard R-CHOP immunochemotherapy for diffuse large B-cell lymphoma (DLBCL) with gastrointestinal (GI) involvement is associated with an increased risk of severe GI complications, includ
APA
Cui K, Wan J, et al. (2026). Safety and efficacy of a pre-phase with dexamethasone followed by fractionated R-CHOP in diffuse large B-cell lymphoma patients with gastrointestinal involvement at diagnosis.. Annals of hematology, 105(2), 56. https://doi.org/10.1007/s00277-026-06824-5
MLA
Cui K, et al.. "Safety and efficacy of a pre-phase with dexamethasone followed by fractionated R-CHOP in diffuse large B-cell lymphoma patients with gastrointestinal involvement at diagnosis.." Annals of hematology, vol. 105, no. 2, 2026, pp. 56.
PMID
41575595
Abstract
[BACKGROUND] Standard R-CHOP immunochemotherapy for diffuse large B-cell lymphoma (DLBCL) with gastrointestinal (GI) involvement is associated with an increased risk of severe GI complications, including perforation and acute hemorrhage. This study evaluates a modified treatment regimen aimed at reducing these risks without compromising therapeutic efficacy.
[METHODS] We retrospectively analyzed 65 DLBCL patients with GI involvement. Group 1 ( = 33) received a 3-day pre-phase dexamethasone (DEX) followed by a fractionated R-CHOP regimen (cyclophosphamide, doxorubicin, and vincristine split on days 1 and 4) in cycle 1, then transitioned to standard R-CHOP from cycle 2 onwards. Group 2 ( = 32) received six cycles of standard R-CHOP without pretreatment.
[RESULTS] No treatment-related GI perforation or acute hemorrhage occurred in Group 1, compared with an incidence of 18.7% in Group 2 ( = 0.03). There were no significant differences in overall response rate (84.9% vs. 82.7%), 5-year progression-free survival (73.0% vs. 68.1%; = 0.62), or 5-year overall survival (83.7% vs. 78.0%; = 0.58). Hematologic toxicities were comparable between groups, and no treatment-related deaths occurred in Group 1.
[CONCLUSION] A pre-phase of dexamethasone followed by fractionated R-CHOP in the first cycle, before transitioning to standard R-CHOP, significantly reduces the incidence of GI complications while preserving therapeutic efficacy in DLBCL patients with GI involvement. This approach offers a safer induction strategy without compromising survival outcomes.
[METHODS] We retrospectively analyzed 65 DLBCL patients with GI involvement. Group 1 ( = 33) received a 3-day pre-phase dexamethasone (DEX) followed by a fractionated R-CHOP regimen (cyclophosphamide, doxorubicin, and vincristine split on days 1 and 4) in cycle 1, then transitioned to standard R-CHOP from cycle 2 onwards. Group 2 ( = 32) received six cycles of standard R-CHOP without pretreatment.
[RESULTS] No treatment-related GI perforation or acute hemorrhage occurred in Group 1, compared with an incidence of 18.7% in Group 2 ( = 0.03). There were no significant differences in overall response rate (84.9% vs. 82.7%), 5-year progression-free survival (73.0% vs. 68.1%; = 0.62), or 5-year overall survival (83.7% vs. 78.0%; = 0.58). Hematologic toxicities were comparable between groups, and no treatment-related deaths occurred in Group 1.
[CONCLUSION] A pre-phase of dexamethasone followed by fractionated R-CHOP in the first cycle, before transitioning to standard R-CHOP, significantly reduces the incidence of GI complications while preserving therapeutic efficacy in DLBCL patients with GI involvement. This approach offers a safer induction strategy without compromising survival outcomes.
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