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Abstract
DLBCL is the commonest type of lymphoma. The mainstay of treatment is chemotherapy. Earlier response is associated with better survival. Anthracyclines are effective but cardiotoxic. This is a randomized pilot trial of 50 adult patients with DLBCL conducted at Kasr Alainy oncology department, ages 18 years-65 years) pathologically proven as DLBCL stages I bulky - IV according to Ann Arbor classification, ECOG Performance status < 3. Patients were treated with standard dose 3 weekly R - CHOP for 3 cycles. Those achieved partial remission were randomized to either continue R - CHOP or to shift to ESHAP + / - rituximab. All patients were randomized also to either receive prophylactic carvidolol plus enalapril or not to receive them. Troponin I, echocardiography chest, abdomen and pelvic CT scan were used to re - assess the patients. 50 patients were enrolled between May 2013 and September 2014. median age was 51 years. Better outcome with non shift group ( RR = 90.9 % Vs 66.67%). The 12 month DFS in the continue group was 75 % while in ESHAP group was 58% which is statistically significant (p value = 0.049). The 12 month OS was 100 % in the continue group versus 68 % in the ESHAP group which is statistically significant (p value = 0.003). No early cardiotoxicity was encountered in the whole group. These results should be confirmed on larger scale studies