P13-3 Outcomes and cost effectiveness of treatment of diffuse large B cell non-Hodgkin’s lymphoma with gemcitabine based second salvage chemotherapy

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL), it has a 5 year survival rate of around 60-70% and around 50% patients become refractory to treatment or relapse subsequently. Those with relapsed or refractory disease are treated with salvage chemotherapy, using agents different from those used in upfront therapy, followed by high-dose therapy and autologous stem cell transplantation (HDT-ASCT). Around 30-40% of those with relapse or refractory disease who are consolidated with HDT-ASCT after first salvage chemotherapy suffer from relapse. It is a common practice to treat patients with relapsed or refractory DLBCL, with up to 2 lines of salvage chemotherapy. This study analyzes treatment responses and outcomes with respect to progression free survival (PFS) and overall survival (OS) to second salvage chemotherapy in relapsed and/or refractory DLBCL. This was a retrospective analysis of 55 patients of non-Hodgkin lymphoma treated at SKMCH&RC over the span of 25 years, including 55 patients who received gemcitabine based chemotherapy as second salvage regimen. A total of 35 out of 55 patients (63%) patients received GDP 1-6 cycles of GDP with an average number of 3 cycles for each patient. Out of these 35 patients, 22 (63%) were alive at the time of analysis and 8 patients (23%) had died while 5 (14%) had lost to follow up. Our study proves that, in our part of world where rituximab is not available to every patient because of cost limitations, second salvage Gemcitabine based chemotherapy (Gemcitabine/Dexamethasone/Cisplatin) still has a role improving disease free and overall survival.