How do you manage DLBCL in patients with previous anthracycline exposure?
If a young and otherwise healthy patient with normal echocardiogram and no other cardiac risk factors needs treatment for DLBCL, but has previously received 6 cycles of doxorubicin with cumulative dose of around 300 mg/m2 -, would you still offer anthracycline based treated for curative intent DLBCL?
Answer from: Medical Oncologist at Academic Institution
For fit patients with prior anthracycline exposure for non-lymphoma healthcare who are fit for chemotherapy and with preserved LV function, I would recommend considering daR-EPOCH. The history of the regimen was its original development as treatment of relapsed lymphoma after 1L bolus doxorubicin, a...
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Answer from: Medical Oncologist at Community Practice
In a young individual, I would be very reluctant to give an anthracycline, given previous exposure. It is preferred to use a chemotherapy combination that the patient has not been treated with previously, which may be associated with higher response rates. If transplant-eligible, a salvage regimen s...