From the Guidelines
Prednisone dosing for Non-Hodgkin Lymphoma (NHL) typically ranges from 40-100 mg/day when used as part of combination chemotherapy regimens, with the most common dose being 60 mg/m² for 5 days every 3-4 weeks as part of the R-CHOP regimen. The R-CHOP regimen, which includes Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone, is the standard first-line treatment for many NHL subtypes 1. For an average-sized adult, this translates to approximately 100 mg daily for 5 consecutive days per cycle. The prednisone is usually taken orally with food to minimize gastrointestinal side effects. Some key points to consider when using prednisone in NHL treatment include:
- Treatment typically continues for 6-8 cycles, depending on the stage and aggressiveness of the lymphoma 1.
- Prednisone works in NHL treatment by suppressing the immune system and directly inducing apoptosis (cell death) in lymphoma cells.
- Patients should be monitored for common side effects including hyperglycemia, mood changes, insomnia, increased appetite, fluid retention, and susceptibility to infections.
- Gradual tapering rather than abrupt discontinuation is recommended when completing the regimen to avoid adrenal insufficiency. It's also important to note that chronic prednisone therapy, either medium dose (10–20 mg orally daily) or high dose (> 20 mg orally daily) for more than 4 week duration, increases the likelihood of HBV reactivation into a high risk of reactivation 1. Therefore, patients receiving prednisone as part of their NHL treatment should be closely monitored for signs of HBV reactivation.
From the Research
Prednisone Dose for Non-Hodgkin Lymphoma (NHL) Treatment
- The typical prednisone dose for NHL treatment varies, but common dosages include:
- A study published in the British Journal of Cancer found that a dose of 100 mg/m2/day for 5 days was effective in treating NHL patients 3
- Another study published in The Oncologist found that the most frequently used dosages are 100 mg/day for 5 days (67%), 100 mg/m2/day for 5 days (17%), and 60 mg/m2/day for 5 days (13%) 2
- A retrospective study published in the International Journal of Hematology found that a prednisolone dose of 50 mg/m2/day for 5 days was effective and safe for patients with indolent B-cell NHL 4
- A phase 1b study published in The Lancet Oncology used a standard R-CHOP regimen with prednisone, but did not specify the exact dose of prednisone used 5