Efficacy of DHAP chemotherapy in relapse non-Hodgkin’s lymphoma

Abstract

19538 Background: Survival of relapse non-Hodgkins lymphoma is poor, so many different salvage chemotherapy regimen were utilized. We investigated whether DHAP combination chemotherapy is effective. Methods: Sixthy patients with progressive recurrent lymphoma were treated with a combination of Cisplatin 100 mg/m2 intravenously (IV) by continuous infusion over 24 hours, followed by cytosine arabinoside in two pulses each at a dose of 2 g/m2 given 12 hours apart. Dexamethasone, 40 mg IV, was given on days 1 through 4. Vigorous hydration was reinforced by routine use of mannitol. Treatments were repeated at 3- to 4-week intervals for six courses. The primary end point was a response after six cycles. Results: All patients had not achieved complete remission (CR) with prior therapies, which included cyclophosphamide, adriamycin, vincristine, and prednisolone. Median patient age was 42 years (15–70). Intermediate grade lymphoma was the most frequent pathologic diagnosis. 19 (32%) patients achieved CR, and 17 (28%) patients achieved partial remission (PR). Eleven (18%) patients died during six cycles of chemotherapy.After 2-years follow-up, median survival of patients was 53%. Organomegaly, lymphadenopathy, underlying diseases, and lactic acid dehydrogenase (LDH), were prognostic factors. Neutropenia was the most frequent complication (55%) of this regimen. Conclusions: DHAP has proven to be an effective regimen for patients with relapsing or refractory lymphoma with acceptable toxicity profile and may need further investigations. No significant financial relationships to disclose.