A real-world study reveals that re-treating diffuse large B-cell lymphoma (DLBCL) patients with R-CHOP chemotherapy can achieve durable responses. The research found a 54% two-year time to progression in patients experiencing late relapse, defined as occurring more than two years after initial diagnosis.
Investigators analyzed 65 patients with de novo DLBCL who had relapsed more than two years after their initial rituximab-based treatment. At the time of relapse, these patients had a median age of 77 years, with most presenting with advanced disease (stage III-IV) and a significant portion having poor performance status or high International Prognostic Index scores.
The median time from original diagnosis to relapse was 7.4 years. Patients received a median of five cycles of R-CHOP-like therapy. The treatment yielded an overall response rate of 72%, with 57% achieving a complete response. After a median follow-up of 31 months, key survival metrics were encouraging: 54% had not progressed within two years, 46% were progression-free at two years, and 64% had survived disease-specifically at two years.
Notably, patients relapsing more than five years from their initial diagnosis demonstrated significantly better outcomes. Their two-year time to progression was 66%, compared to just 9% for those relapsing between two and five years.
These findings suggest that R-CHOP re-treatment can offer meaningful benefits and durable disease control for selected patients with late-relapsing DLBCL. This approach is particularly relevant for older patients or those with comorbidities who may not be candidates for more intensive secondary treatments. The timing of relapse appears to be a critical factor in treatment selection.