Modified outpatient dexamethazone, cytarabine and cisplatin regimen may lead to high response rates and low toxicity in lymphoma

ABSTRACT

Our purpose was to investigate the efficacy of and establish a toxicity profile for a modified regimen of dexamethasone, cytarabine and cisplatin [DHAP] for lymphoma outpatients. Fifty-one lymphoma patients, 26 with Hodgkin's disease and 25 with non-Hodgkin's lymphoma, were included. The patients' median age was 32 years [range 17-61]. Twenty had progressive/refractory disease and 31 relapsed disease. Twenty-five were in clinical stage I/II and 26 in clinical stage III/IV before the initiation of salvage chemotherapy. DHAP consisted of dexamethasone [40 mg i.v. on days 1-4], cytarabine [2 g/m[2] i.v. as 3-hour infusion on days 2 in the evening and 3 in the morning] and cisplatin [35 mg/m[2] as 2-hour infusion on days 1-3] were administered every 21 days. A total of 154 cycles of modified DHAP were administered, with a median of 3 cycles per patient [range 2-4]. The main toxicity was myelosuppression. WHO grade III-IV neutropenia and grade III-IV thrombocytopenia were observed in 27 [52.9%] and 21 [41%] patients, respectively. The overall response rate [85% for Hodgkin's disease and 95% for non-Hodgkin's lymphoma] was 88.3% [39.2% complete response and 49.1% partial response]. The results showed that this outpatient schedule of DHAP was well tolerated and an effective salvage regimen