Clinical observation of HyperCVAD/HDMTX-L regimen as salvage treatment for patients with diffuse large B-cell lymphoma

Abstract

Objective To evaluate the efficacy and safety of HyperCVAD/HDMTX-L regimen as salvage treatment for patients with diffuse large B-cell lymphoma. Methods A retrospective study was made to analyze the efficacy and adverse reaction of HyperCVAD/HDMTX-L regimen as salvage treatment for 54 patients with diffuse large B-cell lymphoma. 27 cases were divided in CHOP class scheme ineffective group, 24 cases in recurrence group, HyperCVAD/MA regimen were as the control group. The efficacy in the treatment of 4 cycles, side effects of all cycles and 3-year progression free survival rates of the two regimens were compared. Results In CHOP class scheme ineffective group, efficiency rate of HyperCVAD/HDMTX-L was 59.3 % (16/27), 3y PFS rate was 73.3 %, efficiency rate of HyperCVAD/MA was 61.9 % (13/21), 3y PFS rate was 61.5 %. There was no significant difference in efficiency and PFS rate between the two groups(P >0.05). In recurrence group, efficiency rate of HyperCVAD/HDMTX-L was 47.8 % (11/23), 3y PFS rate was 54.5 %, efficiency rate of HyperCVAD/MA was 45.5 % (10/22), 3y PFS rate was 50.0 %, there was no significant difference in efficiency and PFS rate between the two groups(P > 0.05). The incidence rates of nausea and vomiting, aleukocytosis, thrombocytopenia, hemorrhage associated with chemotherapy in HyperCVAD/HDMTX-L group were significantly lower than those in the control group (all P < 0.001). Conclusion HyperCVAD/HDMTX-L regimen maybe replace HyperCVAD/MA as the salvage treatment of diffuse large B-cell lymphoma. Key words: Lymphoma, large B-cell, diffuse; Salvage therapy; Methotrexate; L-asparaginase