R-mini-CHOP:

Drug Dose Schedule Cycles Common Toxicities
Rituximab (R) 375 mg/m² Day 1 6 Infusion reactions, increased risk of infections
Cyclophosphamide (C) 400 mg/m² Day 1 6 Myelosuppression, nausea, alopecia, hemorrhagic cystitis
Doxorubicin (H) 25 mg/m² Day 1 6 Cardiotoxicity, myelosuppression, alopecia, nausea
Vincristine (O) 1 mg (fixed dose) Day 1 6 Peripheral neuropathy, constipation
Prednisone (P) 40 mg/m² Days 1-5 6 Hyperglycemia, osteoporosis, mood changes, insomnia

Treatment Schedule:

  • One cycle every 21 days
  • Total of 6 cycles

Additional Notes:

  • G-CSF support may be used at physician discretion
  • Antiemetics (e.g. 5-HT3 antagonists) should be given with each cycle
  • Tumor lysis syndrome prophylaxis as needed
  • Dose adjustments or delays may be necessary based on toxicities
  • PET/CT scan typically performed after 3-4 cycles and at end of treatment to assess response

This regimen is specifically designed for elderly or frail patients who may not tolerate full-dose R-CHOP. The “mini” doses aim to reduce toxicity while maintaining efficacy in limited stage DLBCL