EFFICACY AND SAFETY OF RITUXIMAB PLUS DOSE ADJUSTED ETOPOSIDE, PREDNISONE, VINCRISTINE, CYCLOPHOSPHAMIDE AND DOXORUBICIN (R-DA-EPOCH) REGIMEN IN HIGH GRADE DIFFUSE LARGE B- CELL LYMPHOMA PATIENTS (HG-DLBCL)

Abstract

Objective: To determine the efficacy and safety of rituximab plus dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (R-DA-EPOCH) regimen in patients with high-grade diffuse large B-cell lymphoma (HG-DLBCL).

Study Design: Descriptive case series.

Methodology:  A This study was coducted at the  Department of Medical Oncology, INMOL Hospital, Lahore. A total of 87 patients aged 18–60 years diagnosed with HG-DLBCL were included through non-probability consecutive sampling. All patients received six cycles of R-DA-EPOCH every three weeks, followed by FDG-PET/CT evaluation four weeks after treatment completion.

Results: The mean age of patients was 48.6 ± 9.3 years, with 57.5% males. Complete response was achieved in 65.5% of patients, and partial response in 18.4%, yielding an overall response rate of 83.9%. Non-response and disease progression were observed in 9.2% and 6.9% of patients, respectively. Hematologic toxicities such as neutropenia, anemia, and thrombocytopenia were common but manageable. No treatment-related mortality occurred, and 93.1% of patients completed all chemotherapy cycles.

Conclusion: It is concluded that the R-DA-EPOCH regimen is an effective and well-tolerated treatment option for high-grade DLBCL, achieving high response rates with acceptable toxicity.