DISCUSSION
leukopenia, toxicities, thrombocytopenia, SD, anemia, DLBCL, PD, deaths
DISEASE PROGRESSION, LEUKOPENIA, DISEASE, THROMBOCYTOPENIA, ANEMIA, ADVERSE EVENT, LYMPHOMA
The primary analysis of the study, with a follow‐up of at least 44 months, showed that decitabine in combination with the RDHAP regimen resulted in a 40% in ORR, an OS of 17 months, and a PFS of 7 months (Figure Decitabine, an epigenetic drug, has emerged as a promising treatment option for lymphoma.At the last follow‐up, 64.2% (9/14) of the patients in the decitabine‐RDHAP group had progressed or relapsed, indicating that the long‐term disease control rate of this regimen was limited. Therefore, patients should actively seek alternative treatment to achieve optimal survival. Seven patients in the decitabine‐RDHAP group underwent transplantation or CAR‐T therapy, and four achieved long‐term survival. Among patients with SD or PD, some patients with better constitution chose chemotherapy to control disease progression. In addition, eight patients in the decitabine‐RDHAP group responded to subsequent therapy, which could be associated with the delayed chemosensitization effect of decitabine.In subgroup analysis, the decitabine‐RDHAP group showed a greater PFS benefit among patients who were female, with refractory disease, aged >50 years, or had one previous line of therapy treatment. Among patients who were female or had undergone one previous line of therapy treatment, the decitabine‐RDHAP group showed a greater OS benefit (Figure This study revealed no deaths associated with decitabine treatment. The most common hematological toxicities were thrombocytopenia (74% of patients), leukopenia (86%), and anemia (57%) (Table Adverse eventsAbbreviations: AE, adverse event; ALT, glutamic‐pyruvic transaminase; AST, glutamic oxaloacetic transaminase; RDHAP, rituximab, cisplatin, cytarabine, dexamethasone.At present, there are some limitations in the study, there are few clinical studies on the treatment of DLBCL with decitabine in China. In addition, many of the patients received other treatment strategies after participating in our study. Besides, our research may be confined to a small sample size. To further study the effect of decitabine combined with RDHAP regimen in DLBCL, more elaborate randomized controlled trial design are needed in subsequent studies.In conclusion, our study indicates that the decitabine‐RDHAP regimen is effective and well‐tolerated and is a promising salvage regimen for patients with R/R‐DLBCL.