Impact of Omission/Reduction of Vincristine From R-CHOP in Treatment of DLBCL

Abstract Background The R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) is the standard therapy for patients with diffuse large B-cell lymphoma (DLBCL). However, vincristine is sometimes omitted or reduced owing to side effects. Materials and Methods We retrospectively reviewed newly diagnosed patients with DLBCL with R-CHOP–like chemotherapy in our institute from January 2005 to February 2018 to investigate whether the omission/reduction of vincristine reduced the efficacy of the treatment. We compared the overall survival (OS) with and without the omission/reduction of vincristine from the R-CHOP regimen. Results A total of 576 cases were reviewed, and vincristine was omitted/reduced in 50 (9%) patients. The 4-year OS with and without vincristine omission/reduction for relative dose intensity  Conclusions Excessive dose omission/reduction of vincristine might lead to a substantial loss of efficacy of R-CHOP therapy.