ArticleAnnals of hematology2026
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.
Article in Annals of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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7 authors.
Funding
Abstract
backgroundStandard 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.
methodsWe retrospectively analyzed 65 DLBCL patients with GI involvement. Group 1 (n = 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 (n = 32) received six cycles of standard R-CHOP without pretreatment.
resultsNo treatment-related GI perforation or acute hemorrhage occurred in Group 1, compared with an incidence of 18.7% in Group 2 (p = 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%; p = 0.62), or 5-year overall survival (83.7% vs. 78.0%; p = 0.58). Hematologic toxicities were comparable between groups, and no treatment-related deaths occurred in Group 1.
conclusionA 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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