Abstract
Background and Aim: The treatment of choice for relapsed or refractory Non-Hodgkin Lymphoma (NHL) mainly, is High dose chemotherapy with autologous stem cell transplantation. However, its use is mostly restricted to patients responding to salvage chemotherapy. In this study, our aim was to evaluate outcome and toxicity of different treatment modalities of relapsed and refractory NHL. Patient and Methods: This retrospective study included 217 patients were diagnosed as refractory or relapsed NHL. Those patients received different treatment modalities as GDP (Gemcitabine, dexamethasone, cisplatin), DHAP (Dexamethasone, Cytarabine, and Cisplatin), MINE (Mitoxantrone, ifosfamide, etoposide and mesna), CHOP (Cyclophosphamide, Doxorubicin, Vincristine and Prednisone), and CVP (Cyclophosphamide, vincristine and prednisone). Results: The median age of patients in the study was 50 years. Patients who received DHAP showed ORR of 62%, which was the highest response. The most common adverse effects were hematological which were more noticed in patients, received CHOP. Sixty one patients (54.5%) had anemia, 54 patients (48.2%) had neutropenia and 55 patients (49.1%) had thrombocytopenia, but the difference between the different lines of treatment wasn’t significant p value of 0.95. The median time to relapse is 10 months and the median survival time is 40 months. The 3-year PFS rates of all patients were 49.3%, while the 3 year OS rates were 54.8%. Conclusion: The overall and PFS didn’t show any difference between different lines of treatment.
Highlights
Its use is mostly restricted to patients responding to salvage chemotherapy
Non-Hodgkin Lymphoma (NHL) can be divided into two groups, indolent and aggressive [2]
The aggressive NHLs grow faster and have shorter survival; the number of patients cured with intensive chemotherapy currently has been increasing [4]
Summary
The strategy for management of relapsed or refractory disease is to deliver salvage chemotherapy, followed by high dose chemotherapy and autologous stem-cell transplantation in responding patients [8]. There is no optimal salvage regimen for relapsed or refractory B-cell lymphoma; there are no standard options of treatment for patient’s response to second line regimens, nor for patients who are not eligible for transplant [9]. The treatment of choice for relapsed or refractory Non-Hodgkin Lymphoma (NHL) mainly, is High dose chemotherapy with autologous stem cell transplantation. Patient and Methods: This retrospective study included 217 patients were diagnosed as refractory or relapsed NHL Those patients received different treatment modalities as GDP (Gemcitabine, dexamethasone, cisplatin), DHAP (Dexamethasone, Cytarabine, and Cisplatin), MINE (Mitoxantrone, ifosfamide, etoposide and mesna), CHOP (Cyclophosphamide, Doxorubicin, Vincristine and Prednisone), and CVP (Cyclophosphamide, vincristine and prednisone). Conclusion: The overall and PFS didn’t show any difference between different lines of treatment
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