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Details

Autor(en) / Beteiligte
Titel
(R-)DHAP vs. (R-)IEV as salvage treatment for relapsed or refractory B-cell NHL: comparison of response rates, stem cell mobilisation and toxicity.(Lymphoma)(Non-Hodgkin's lymphomas)(Dihydroxyacetone phosphate)(Ifosfamide, Epirubicin and VP16 )
Ist Teil von
  • Bone marrow transplantation (Basingstoke), 2009-03, Vol.43 (S1), p.S211
Ort / Verlag
Nature Publishing Group
Erscheinungsjahr
2009
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
  • High dose Chemotherapy and auto-SCT is used for consolidation of relapsed/refractory B-NHL after response to salvage treatment. The ideal salvage protocol for stem cell mobilization and cytoreduction remains controversial. Here we report data of a retrospective analysis from a single center regarding the Overall Response Rate (ORR), the stem cell mobilisation, and the toxicity with regard to the salvage chemotherapy used. Methods: The following protocols were used: Ifosfamide, Epirubicin and VP16 (IEV), q21; R-IEV: addition of Rituximab (R) 375 mg/[m.sup.2]. Cisplatin, Cytarabin, and Dexamethason (D-HAP) q21; R-DHAP: addition of R. 375 mg/[m.sup.2]. G-CSF was given at a dose of 5-10micg/kg. (R-)DHAP: 61 patients (pat.) were treated between 9/98 and 4/08. 32/61 pat. received R.. Pat. suffered from B-cell NHL (25 DLBCL, 12 FL, 12 MCL, 12 other NHL). 21 pat. had refractory disease, and 17 early relapse. (R-)DHAP was administered as 2nd line therapy in 34, and [greater than or equal to] 3rd line therapy in 27 pat. 52 DHAP cycles were given in 29 pat. and 68 RDHAP cycles in 32 pat.. (R-)IEV: 82 pat. were treated between 12/97 and 11/03. 14/82 received R.. Pat. suffered from B-cell NHL (26 DLBCL, 44 FL, 12 pat. other NHL). 17 had refractory disease, and 35 relapsed early. (R-)IEV was given as 2nd line therapy in 59, and ??3 rd line therapy in 23 pat.. 142 IEV cycles were given in 68 pat. and 30 R-IEV cycles in 13 pat. Results: After (R-)DHAP the ORR was 42% in 43 evaluable pat. (CR: 7%, PR 35%). The ORR was 60% in 55 evaluable pat. treated with (R-)IEV (CR: 25.5%, PR 34.5%). Stem cells were mobilized in 94.4% after (R-)DHAP compared to 94.5% after (R-)IEV. Transfusions were needed after 29% of (R-)DHAP cycles. Transfusion dependency was 0,75 erythrocyte and 0,30 platelet units/cycle. Fever in neutropenia occurred in 26% of patients with no septic death. 3/61 pat. developed acute renal failure. (R-)IEV: Transfusions were needed after 33% of cycles. Overall transfusion dependency was 0,74 erythrocyte and 0,26 platelet units/cycle. Fever in neutropenia occurred in 44% of the patients, causing death of 3 patients. Conclusion: In both groups the addition of R neither influenced stem cell mobilisation nor the frequency of neutropenic fever. The main toxicity in treatment with (R-)IEV was neutropenic fever and sepsis. In the (R-)DHAP group the main toxicity was acute renal failure. The higher ORR achieved with (R-)IEV compared to (R-)DHAP should be interpretated with care in this retrospective analysis.
Sprache
Englisch
Identifikatoren
ISSN: 0268-3369
eISSN: 1476-5365
Titel-ID: cdi_gale_healthsolutions_A198170556

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