A 55-year-old woman is diagnosed with diffuse large B-cell lymphoma (DLBCL), stage IIIA, with an IPI score of 3. PET-CT shows FDG-avid lymphadenopathy. The standard first-line treatment is:
- A CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) alone
- B R-CHOP (rituximab + CHOP) for 6 cycles ✓
- C R-EPOCH (dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin)
- D ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine)
Correct answer: B. R-CHOP (rituximab + CHOP) for 6 cycles
Explanation
R-CHOP for 6 cycles remains the standard first-line treatment for most patients with DLBCL regardless of stage, based on landmark randomized trials (GELA LNH-98.5, MInT trials). The addition of rituximab (anti-CD20) to CHOP improved overall survival by 10-15%. DA-R-EPOCH is preferred for specific subtypes such as double-hit/triple-hit lymphoma (MYC + BCL2/BCL6 rearrangements) per NCCN guidelines. ABVD is used for Hodgkin lymphoma, not DLBCL.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.