Comparison of Pola-R-CHP and R-CHOP for newly diagnosed DLBCL: A single-center retrospective study

Background Polatuzumab vedotin plus rituximab, cyclophosphamide, doxorubicin, and prednisolone (Pola-R-CHP) has become a first-line treatment option for diffuse large B-cell lymphoma (DLBCL), but real-world data remain limited. We retrospectively compared Pola-R-CHP and R-CHOP in patients with newly diagnosed DLBCL.

We analyzed 127 patients who received first-line Pola-R-CHP (n = 57) or R-CHOP (n = 70) at a single center between January 2021 and August 2025. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS) and adverse events. A 120-day landmark analysis, subgroup analyses, and exploratory analysis for sepsis were also performed.

Median age was 75 years in the Pola-R-CHP group and 79.5 years in the R-CHOP group; patients aged >80 years were more frequent in the R-CHOP group (21.1% vs 47.1%, P = 0.003). 1-year PFS was 83.9% with Pola-R-CHP and 76.9% with R-CHOP (P = 0.56). 1-year OS was 89.8% and 91.1%, respectively (P = 0.61). In the 120-day landmark analysis, no significant difference in PFS was observed (HR 0.68, 95% CI 0.29-1.56, P = 0.36). Infection-related treatment discontinuation was more frequent with Pola-R-CHP (12.3% vs 0%, P = 0.003). Sepsis was also more frequent in the Pola-R-CHP group (14.0% vs 4.3%, P = 0.098).

In this single-center retrospective cohort, Pola-R-CHP was not associated with a significant improvement in PFS compared with R-CHOP. Infection-related treatment discontinuation was more frequent in the Pola-R-CHP group. Sepsis was also numerically more frequent, highlighting the importance of careful infection monitoring in clinical practice.