R-DHAOx

R-DHAOx is a combination chemotherapy regimen used primarily for treating relapsed or refractory B-cell non-Hodgkin lymphoma. The regimen consists of four medications: rituximab, dexamethasone, high-dose cytarabine (Ara-C), and oxaliplatin. ## Composition and Administration R-DHAOx is typically administered as follows: - Rituximab: 375 mg/m² intravenously on day 1 - Dexamethasone: 40 mg daily on days 1-4 - Cytarabine (Ara-C): 2,000 mg/m² twice daily on day 2 - Oxaliplatin: 100 mg/m² intravenously on day 1 The treatment cycle is repeated every 21 days, with the number of cycles determined by the patient's response and tolerance[1][3]. ## Efficacy and Applications This regimen has shown significant efficacy in treating various types of B-cell non-Hodgkin lymphomas, including: - Diffuse large B-cell lymphoma (DLBCL) - Follicular lymphoma (FL) - Mantle cell lymphoma - Marginal zone lymphoma[3][6] In clinical studies, R-DHAOx has demonstrated impressive response rates: - Overall response rates of 71-75% - Complete response rates of 57-68% - Two-year overall survival rates of approximately 75%[3][6] ## Development and Rationale R-DHAOx was developed as a modification of the R-DHAP regimen (rituximab, dexamethasone, high-dose cytarabine, and cisplatin). The key difference is the substitution of oxaliplatin for cisplatin to reduce nephrotoxicity while maintaining efficacy[8]. ## Toxicity Profile The most common adverse effects include: - Hematological toxicities: neutropenia (44%), thrombocytopenia (47%), and anemia - Neurological toxicities: primarily transient sensory or motor neuropathies - Cold sensitivity: patients are advised to avoid cold drinks, food, and ice during treatment and for up to 2 days after oxaliplatin administration[3][5] Importantly, R-DHAOx shows significantly less nephrotoxicity compared to cisplatin-containing regimens, making it suitable for patients with renal impairment[8]. ## Current Applications R-DHAOx is primarily used as: 1. Salvage therapy for relapsed/refractory B-cell non-Hodgkin lymphomas 2. A bridge to autologous stem cell transplantation in eligible patients 3. Part of combination approaches with newer agents like BTK inhibitors (e.g., zanubrutinib)[7] The regimen has shown efficacy across different age groups, though dose adjustments may be considered for patients over 60 years of age[1].

Other names

DHAXR-DHAXDHAX-R regimen