<s>[INST] my dad is 46 years old , he is on the second line R-EShAP protocol he s ESR was 20 after the first cycle and the LDH was 290 . After the second cycle he s ESR became 47 and its LDH remain 290 what does that means . in addtion that my dad had stage 4 diffuse large b cell lymphoma and had 7 cycles of R-CHOP and had about 90 percent response [/INST] Good evening. Your father is on 2nd line therapy after progression on first line treatment. We cannot predict the response based on ESR and LDH as these are non specific markers. Response can only be assessed by imaging, eith a CT scan or PETCT scan. Moreover if he is fit, he can go for marrow transplant as a curative therapy.regards </s>