R-DHAP Regimen

R-DHAP (Rituximab + Dexamethasone, High-dose Cytarabine, Cisplatin)

• Indication:
  • Relapsed/refractory DLBCL, commonly used in salvage setting prior to transplant
  • Alternative to R-ICE or R-ESHAP in high-grade lymphoma
• Eligible Patients:
  • Transplant-eligible patients with good renal and neurologic function
  • Younger patients or fit older adults
• Pros:
  • High-dose cytarabine is effective in aggressive lymphomas
  • Proven efficacy as a bridge to autologous stem cell transplant
  • Can achieve durable remissions in chemosensitive disease
• Key Toxicities:
  • Cerebellar neurotoxicity (cytarabine – monitor for ataxia, confusion)
  • Myelosuppression (high)
  • Renal toxicity (cisplatin)
  • Risk of mucositis, infections, electrolyte imbalances