R-CHOP Retreatment Produces Durable Remissions in Late-Relapsing Diffuse Large B-Cell Lymphoma
Clinical Summary:
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Design/Population: This retrospective, population-based study evaluated 65 patients with de novo diffuse large B-cell lymphoma (DLBCL) who experienced late relapse more than 2 years after diagnosis and were retreated with curative-intent R-CHOP–based therapy.
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Key Outcomes: Retreatment with R-CHOP–based therapy produced an overall response rate of 72%, including a complete response rate of 57%, with durable remissions observed in a subset of patients. Outcomes were significantly better among patients whose disease relapsed more than 5 years after initial diagnosis.
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Clinical Relevance: These findings suggest that R-CHOP retreatment may remain a potentially curative option for selected patients with late-relapsing DLBCL and could offer an alternative to more intensive approaches such as transplantation or CAR T-cell therapy.
Results from a population-based retrospective study demonstrated that retreatment with R-CHOP–based therapy produced durable responses in selected patients with late-relapsing diffuse large B-cell lymphoma (DLBCL), particularly among those whose disease recurred more than 5 years after initial diagnosis.
“It is postulated that a second course of R-CHOP-based therapy may offer a less toxic and less resource-intense option for late-relapsing DLBCL, while still offering curative potential,” stated Jean-Nicolas Champagne, MD, FRCPC, P Hôpital Sacré-Coeur de Montréal, Montreal, Canada, and coauthors. “However, this approach has not been previously evaluated.”
This retrospective analysis included 65 patients with de novo DLBCL who relapsed more than 2 years after their initial diagnosis and received curative-intent R-CHOP–based therapy. The primary end point was time to progression. Secondary end points included overall response rate (ORR), complete response, progression-free survival (PFS), disease-specific survival, and overall survival (OS).
The median interval between initial diagnosis and relapse was 7.4 years, and patients received a median of 5 cycles of R-CHOP–based therapy at relapse.
The ORR was 72%, including a complete response rate of 57% and a partial response rate of 15%. After a median follow-up of 31.4 months, median time to progression was 45.1 months, and the estimated 2-year time to progression rate was 53.7%. Median PFS was 16.1 months, with a 2-year PFS rate of 45.8%. Median disease-specific survival was 59.2 months, with a 2-year disease-specific survival rate of 64.3%, while median OS was 38.6 months, with a 2-year OS rate of 54.3%.
Patients whose disease relapsed more than 5 years after diagnosis experienced significantly better outcomes than those who relapsed between 2 and 5 years, with a 2-year time to progression rate of 66% versus 9%, respectively (hazard ratio [HR], 0.30; 95% confidence interval [CI], 0.14 to 0.64; P = .001).
During follow-up, 36 patients died, with 75% of deaths attributed to lymphoma or treatment-related toxicity. Most patients who did not receive curative-intent retreatment were managed with less intensive systemic therapy, radiotherapy, or supportive care because they were not candidates for more intensive treatment.
“R-CHOP-like therapy yields durable remissions in a high proportion of patients, especially in those relapsing >5 years after diagnosis, allowing many patients to avoid more intensive and costly secondary therapies," concluded Dr Champagne et al.
Source:
Champagne JN, Villa D, Gerrie AS, et al. Retreatment with R-CHOP–like therapy in patients with late relapse of diffuse large B-cell lymphoma. Blood Adv. Published online: January 29, 2026. doi: 10.1182/bloodadvances.2025017620
