ArticleAmerican journal of cancer research2026
A study comparing the efficacy of R-CHOP and R-DA-EPOCH regimens in young, high-risk treatment-naïve diffuse large B-cell lymphoma patients: a multicenter retrospective analysis.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients with high-risk diffuse large B-cell lymphoma (DLBCL) have poor prognoses, and the comparative efficacy between R-CHOP and R-DA-EPOCH regimens remains controversial.
objectiveTo compare the efficacy and safety of R-CHOP and R-DA-EPOCH regimens in young, treatment-naïve patients with high-risk DLBCL.
methodsThis multicenter retrospective cohort study included 148 young, treatment-naïve, high-risk DLBCL patients treated at five tertiary hospitals between March 2023 and March 2025. Patients were divided into the R-CHOP group (n=98) and the R-DA-EPOCH group (n=50). Baseline characteristics, treatment responses, treatment completion, dose intensity, adverse events, and supportive care information were collected. Intergroup comparisons were performed using the Mann-Whitney U test, chi-square test, or Fisher's exact test.
resultsBaseline characteristics were generally balanced between the two groups, except for a significantly higher proportion of ECOG score 1 in the R-DA-EPOCH group (76.0% vs. 50.0%, P=0.007); subsequent multivariate analysis was used to adjust for this difference. The complete response (CR) rate was 46.0% in the R-DA-EPOCH group versus 36.7% in the R-CHOP group, but the difference was not statistically significant (P=0.313); the objective response rates were 58.0% and 61.2%, respectively (P=0.313). Subgroup analysis showed higher CR rates with R-DA-EPOCH in most subgroups, though none reached statistical significance. The relative dose intensity was significantly lower in the R-DA-EPOCH group compared to the R-CHOP group ($0.84\pm 0.06 vs. $0.92\pm 0.04, P<0.001), with significantly higher rates of dose reduction (52.0% vs. 18.4%, P<0.001) and treatment delay (46.0% vs. 18.4%, P=0.001). The R-DA-EPOCH group had significantly higher usage rates of G-CSF (50.0% vs. 31.6%, P=0.033), platelet transfusions (28.0% vs. 8.2%, P=0.003), and a longer median length of hospital stay (7.1 days vs. 4.9 days, P<0.001). Baseline LDH levels showed no significant correlation with treatment response (P=0.561).
conclusionCompared with R-CHOP, the R-DA-EPOCH regimen showed a trend toward higher CR rates in young, treatment-naïve, high-risk DLBCL patients, but this did not reach statistical significance. Moreover, R-DA-EPOCH was associated with significantly increased hematological toxicity and supportive care burden. Clinicians should carefully weigh the potential benefits against the risks when selecting this regimen.
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