R-CDOP Regimen in the Treatment of Newly Diagnosed Non-Hodgkin's Lymphoma With High Tumor Burden

Other illness

• Hypersensitivity to any study drug or its ingredients;
• Patients with significant and uncontrolled cardiovascular disease or history;
• Persons with mental disorders/unable to obtain informed consent;
• Previous history of malignant tumor;
• HIV infection; HBV infection (HBV-DNA\> 2000 IU/ml);HCV infection (HCV-RNA\>200 IU/ml);

Lab values

• Abnormal liver function \[total bilirubin \> 1.5 times of the upper limit of normal value; Alanine aminotransferase/Aspartate aminotransferase (ALT / AST) \> 2.5 times of upper limit of normal value for patients without liver metastasis ; ALT / AST \> 5 times of upper limit of normal value for patients with liver metastasis \], abnormal renal function (serum creatinine \> 1.5 times of upper limit of normal value) ;
• Absolute Neutrophil Count (ANC)\<1.5×10\^9/L or Platelet (PLT)\< 75 × 10\^9/L;

Age

• Pregnant or lactation and patients of childbearing age who do not want to take contraceptive measures;

Other

• Lymphoma infiltrates the central nervous system;
• The investigator determined not suitable to participate in this study.

• Histologically immunohistochemistry and imaging confirmed diffuse large B-cell lymphoma or follicular lymphoma grade 3B;
• Has at least one evaluable or measurable lesion according to Lugano response criteria;
• Patients with at least one of the following high tumor burden Involvement of at least 3 nodal sites (each with a diameter greater than 3 cm); nodal or extranodal mass \> 7cm in its greater diameter; Hepatomegaly and splenomegaly (infiltration confirmed by PET-CT; Spleen: female \> 15cm, male \> 16cm); Pleural/peritoneal effusion; Lactate dehydrogenase (LDH) three times the upper limit of normal; PET-CT TMTV \>220cm3;
• Patients previously untreated;
• Patients aged over 18 and under 75 years;
• Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0\~2;
• International Prognostic Index (IPI) score \> 1, or with extranodal mass diameter ≥7cm;
• Life expectancy ≥ 6 months;
• Left Ventricular Ejection Fraction (LVEF) ≥ 50%;
• Patients must sign informed consent and be willing and able to comply with the requirements of visits, treatment, laboratory tests and other research requirements stipulated in the research schedule.