Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter January 13, 2020

Evaluation to the chemotherapy use in patients with diffuse large B-cell lymphoma

  • Dirani Dirani , Suharjono EMAIL logo , Made Sedana , Siti Wahyuni , Chrismawan Ardianto and Chris Alderman



Non-Hodgkin lymphoma (NHL) is a large group of primary malignancies of solid lymphoid tissue. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of NHL. DLBCL has an aggressive natural history but responds well to chemotherapy. The objective of this study was to review the use of chemotherapy, identify its side effects, and examine the response to chemotherapy in patients with NHL at Dr. Soetomo General Hospital.


This study was a retrospective observational study using secondary data obtained from patients’ medical records from 2016 to 2018. Demographic data (age, sex), clinical characteristics, chemotherapy regimens, side effects of chemotherapy, and response to chemotherapy were recorded.


Results revealed that of the 43 patients (age ranged from 21 to 80 years) who were included in this study, the prevalence of DLBCL was higher in male patients (74%) and about 44% patients were at stage III. R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine/oncovin, prednisone) (53%) was the most used chemotherapy regimen in this study. A total of 65% of patients showed good responses and 35% showed no response to the therapy. The most common side effect was myelosuppression, including 25% and 8% of the patients having anemia and leukopenia, respectively.


R-CHOP is the most used regimen. Most of patients with NHL have a complete response and the predominant side effect is anemia.


The author thanks the Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Airlangga.

  1. Research funding: The author thanks to Tahir Professorship program from Tahir Foundation.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ institutional review board.


[1] Fausel C. Chapter 90: Malignant Lhymphomas. In: Chishol-Burns MA, Wells BG, Schwinghammer TL, Malone PM, Kolesar JM, Rotschafer J, et al., editors. Pharmacotherapy principle and practice. USA: The McGraw-Hill Education, 2008:1371–84.Search in Google Scholar

[2] Hecht KA, Liewer SE. Malignant Lymphomas. In: Chisholm-Burns MA, Schwinghammer TL, Wells BG, Malone PM, Kolesar JM, Dipiro JT, editors. Pharmacotherapy principles and practice, 4th ed. New York: The McGraw-Hill Education, 2016:1433–59.Search in Google Scholar

[3] American Cancer Society. 2018. Chemotherapy for non-Hodgkin lymphoma. American Cancer Society. Available at: Accessed: 28 Oct 2018.Search in Google Scholar

[4] Dark GG. The global burden of cancer. In: Dark GG, editor. Oncology at a glance, 1st ed. UK: John Wiley & Sons, Ltd, 2013:10–11.Search in Google Scholar

[5] Kementerian Kesehatan Republik Indonesia. Data dan Kondisi Penyakit Limfoma di Indonesia. Jakarta: Kementerian Kesehatan Republik Indonesia, 2015:1–4.Search in Google Scholar

[6] Reksodiputro AH. Multicentre epidemiology and survival study of B cell non Hodgkin lymphoma patients in Indonesia. J Blood Disorder Transfusion 2015;6:1–5.10.4172/2155-9864.1000257Search in Google Scholar

[7] Jacobson JO, Polovich M, Gilmore TR, Schulmeister L, Esper P, LeFebvre KB, et al. Revisions to the 2009 American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards: expanding the scope to include inpatient settings. Oncol Nurs Forum 2012;39:31–8.10.1188/12.ONF.31-38Search in Google Scholar PubMed

[8] Mansi J. Generic chemotherapy protocol guidelines. London, England: NHS South East London Cancer Network, 2013:3–5.Search in Google Scholar

[9] NCCN. Non-Hodgkin’s Lymphomas. London, England: National Comprehensive Cancer Network, 2014:58–70.Search in Google Scholar

[10] Castillo JJ, Ghobrial IM, Treon SP. Biology, prognosis, and therapy of Waldenström macroglobulinemia. Cancer Treat Res 2015;165:177–96.10.1007/978-3-319-13150-4_7Search in Google Scholar PubMed

[11] Ondrejka SL, Hsi ED. Pathology of B-cell lymphomas: diagnosis and biomarker discovery. Cancer Treat Res 2015;165:1–26.10.1007/978-3-319-13150-4_2Search in Google Scholar PubMed

[12] Winkfield KM, Tsang RW, Gospodarowicz MK. Chapter 77: non-hodgkin’s lymphoma. In: Winkfield KM, Tsang RW, Gospodarowicz MK, editors. Clinical radiation oncology. Philadephia: Elsevier; 2016:1524–46.10.1016/B978-0-323-24098-7.00077-0Search in Google Scholar

[13] Jaffe ES, Pittaluga S, Anastasi J. Chapter 73: the pathologic basis for the classification of non-hodgkin and hodgkin lymphomas. In: Hoffman R, Benz EJ, Silberstein LE, Heslop H, Weitz J, Anastasi J, editors. Hematology: diagnosis and treatment. Philadephia: Elsevier, 2018:1187–203.10.1016/B978-0-323-35762-3.00073-1Search in Google Scholar

[14] Rubenstein JL, Gupta NK, Mannis GN, LaMarre AK, Treseler P. How I treat CNS lymphoma. American Society of Hematology. Blood 2013;122:3061–7.10.1182/blood-2013-06-453084Search in Google Scholar

[15] ASCO. 2015. Understanding Targeted Therapy. American Society of Clinical Oncology. Available at: Accessed: 30 Oct 2018.Search in Google Scholar

[16] Chiu BC, Hou N. Epidemiology and etiology of non-Hodgkin lymphoma. Cancer Treat Res 2015;165:1–26.10.1007/978-3-319-13150-4_1Search in Google Scholar PubMed

[17] Salma RS, Bintoro UY, Sedana MP. CHOP and R-CHOP therapeutic responses in non-Hodgkin lymphoma patients in Dr. Soetomo General Hospital Surabaya. Biomol Health Sci J 2018;2:93–6.10.20473/bhsj.v1i2.9244Search in Google Scholar

[18] BCCA. BC cancer agency cancer drug manual, doxorubicin. London, England: BC Cancer Agency, 2017:1–9.Search in Google Scholar

[19] Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendation for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014;32:3059–67.10.1200/JCO.2013.54.8800Search in Google Scholar PubMed PubMed Central

[20] Gordon KA, Tosti A. Alopecia: evaluation and treatment. Clin Cosmet Investig Dermatol 2011;4:101–6.10.2147/CCID.S10182Search in Google Scholar PubMed PubMed Central

Received: 2019-11-08
Accepted: 2019-11-25
Published Online: 2020-01-13

© 2019 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 2.6.2023 from
Scroll to top button