high dose cytarabine with dexamethasone and cisplatin [DHAP] solve the problem of patients with relapsed non-Hodgkin's lymphoma?

Between 2001 and 2002, 56 patients with refractory or relapsing non-Hodgkin lymphoma after prior anthracycline based chemotherapy were treated with DHAP [dexamethasone, high dose cytarabine and cisplatin]. After 6 cycles, 28.8% of patients [16/56] achieved complete response, while 58.9% [33/56] attained partial response. The overall survival at 2 years was 25%. Myelosuppression was the major toxicity; 24 patients [42.85%] had grade IV neutropenia and 39 patients [69.64%] had grade III-IV thrombocytopenia, but there was no treatment-related death. DHAP regimen is an effective salvage therapy for the patients with relapsed and refractory NHL, but the response duration time is short and long-term prognosis remains poor; high dose chemotherapy with autologous bone marrow transplantation is necessary for improvement in long-term survival

role of gemcitabine and cisplatin as first line therapy in patients with advanced ovarian carcinoma

This study included 40 patients with histopathologically proved advanced stages III and IV ovarian carcinoma according to 1998 criteria of International Federation of Gynecology and Obstetrics [FIGO] staging system. Patients were divided into two groups: Group I: a prospectively studied group of 20 previously untreated patients, seen during the period from December 1999 to December 2000, who received cisplatin [100mg/m[2]] day I and gemcitabine [1250mg/m[2]] day and day 8 and the cycle was repeated every 21 days. Group II: a retrospectively 20 patients, fulfilling the same eligibility criteria, who received cisplatin [100mg/m[2]] and cyclophosphamide [750mg/m[2]], both in day I and the cycle was repeated every 21 days. All patients in both groups received a total of six courses of treatment and the response was determined by clinical examination as well as pelvi-abdominal ultrasound, and pelvi-abdominal computed tomography. Complete response was achieved in 35% of cases in group I vs 15% in group II, while partial response was obtained in 35% in both groups. There were no statistical significant difference between overall response rate [O.R.R] in both groups [X2 = 3.86, P 0.277]. Patients who received gemcitabine/ cisplatin combination chemotherapy showed less anemia and less renal toxicity with better tolerance than the cyclophosphamide / cisplatin arm. There were no statistical significant difference between overall survival [O.S] in both arms, however the progression free survival [P.F.S] was better in group I and reached the level of significance compared to group II [P=0.03]