Chemoimmunotherapy for DLBCL
Medically reviewed by: Carla Casulo, MD
Last Updated: August 2026
Chemoimmunotherapy for DLBCL is the most common treatment for DLBCL. It combines chemotherapy with immunotherapy. Chemotherapy uses drugs to kill cancer cells. Immunotherapy uses drugs that use the body’s natural defenses (the immune system) to fight cancer. This is a systemic (whole body) treatment. This means it can destroy cancer cells almost anywhere in your body. It may be given by IV (through a vein or port), in pill form (by mouth), or as an injection (a shot).
There are different drugs and drug combinations used to treat DLBCL. Your doctor will explain which treatment is best for you and how many cycles you will need. A cycle means you get treatment for a set amount of time, then you get a break to let your body recover.
These are the drugs and chemoimmunotherapy combinations that are used most often. New treatments become available all the time, so this may not be a complete list.
Please note: The side effects listed here do not represent a comprehensive list. Each therapy and drug has its own set of side effects and ways of working. The side effects of chemoimmunotherapy depend on the drug(s) you take, the dose, and how often you get treatments. It's important to discuss all potential side effects with your healthcare team. Be sure to tell them about any side effects you have.
This is the standard first treatment for DLBCL at any stage. R-CHOP is made up of 5 drugs given at once:
R – rituximab, an immunotherapy drug
C – cyclophosphamide, a chemotherapy drug
H – doxorubicin (also known as hydroxydaunorubicin), a chemotherapy drug
O – vincristine (previously called oncovin), a chemotherapy drug
P – prednisone, a steroid
This is a treatment that is suitable for patients with advanced DLBCL (stage 3 or 4). Pola-R-CHP is made up of 4 drugs given at once:
P – polatuzumab vedotin (also known as pola), an immunotherapy drug
R – rituximab, an immunotherapy drug
C – cyclophosphamide, a chemotherapy drug
H – doxorubicin (also known as hydroxydaunorubicin), a chemotherapy drug
P – prednisone, a steroid
This is a strong treatment given as a continuous IV infusion for 96 hours. It is used for certain aggressive subtypes of DLBCL. This treatment is made up of 4 drugs given at once:
R – rituximab, an immunotherapy drug
E – etoposide, a chemotherapy drug
P – prednisone, a steroid
O – vincristine (previously called oncovin), a chemotherapy drug
C – cyclophosphamide, a chemotherapy drug
H – doxorubicin (also known as hydroxydaunorubicin), a chemotherapy drug
All Available Treatments
Pill = 
Treatment Type
Chemotherapy
Drug Names
Potential Severe Side Effects
Infections
Heart problems
Lung problems
Kidney problems
Liver problems
Fertility issues
Secondary cancer
Potential Side Effects
Fever
Fatigue/weakness
Hair thinning/loss
Mouth sores
Weight/appetite changes
Nausea/vomiting
Diarrhea
Constipation
Skin/nail changes
Numbness/tingling in the hands or feet
Low blood counts
Important Things to Know
- Chemo drugs kill cancer cells but also can damage normal cells, which can lead to side effects. These depend on the type and dose of drugs given and how long they are taken.
- Most side effects go away after treatment is finished.
- Along with these short-term side effects, some chemo drugs can cause long-term damage to certain organs. Doctors weigh the risks and benefits of these drugs carefully. They also check how well your organs are working during treatment.
- If you have side effects, your cancer care team can suggest steps to ease them. For example, preventive drugs are given along with the chemo to prevent or reduce nausea and vomiting.
- These drugs may cause harm to your unborn baby.
- If you want to preserve your fertility, talk with your doctor before starting chemotherapy.
- Low blood counts may put you at risk for anemia, infection, bleeding, or bruising.