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DA-EPOCH-RR is a dose-adjusted chemoimmunotherapy regimen consisting of etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab, specifically administered for three cycles as part of a risk-adapted treatment strategy. Developed by the National Cancer Institute (NCI), this regimen is primarily evaluated for the treatment of highly aggressive B-cell malignancies, including Burkitt lymphoma, c-MYC-positive diffuse large B-cell lymphoma (DLBCL), and plasmablastic lymphoma. The dose-adjusted (DA) component involves tailoring the doses of etoposide, doxorubicin, and cyclophosphamide based on the patient's hematologic nadir from the previous cycle to maximize therapeutic efficacy while minimizing toxicity. The RR designation in clinical trial contexts typically refers to the reduced-cycle arm (3 cycles) intended for patients identified as low-risk, contrasting with the standard 6-cycle DA-EPOCH-R regimen.
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