[Evaluation of therapeutic effects of dexamethasone, high-dose cytosine arabinoside and cisplatin regimen on patients with relapsed lymphoma]

ABSTRACT

Recurrence of hematologic malignancies are one of the main problems after early management of these diseases. Due to the poor survival, several salvage regimens have been suggested. To evaluate the efficacy and safety of DHAP regimen in relapsed lymphoma, we conducted this prospective trial. Sixthy patients with progressive relapsed lymphoma were treated with a combination of Cisplatin 100 mg/m[2] [continuous IV infusion over 24 hours] followed by Cytosine Arabinoside in two pulses [each at a dose of 2 g/m[2] given 12 hours apart]. Dexamethasone [40mg IV] was given on days 1 through 4. Vigorous hydration was reinforced by routine use of mannitol. Cycles were repeated at 3-4 weeks interval for six courses. The primary aim was to evaluate the response after six cycles. Patients had a median age of 42 years old [15-70 years]. They all had relapsed during or less than one year after first line chemotherapy. Out of 60 patients, 19 [32%] achieved complete remission, whereas 17 [28%] experienced partial remission. Eleven patients [18%] expired during treatment. The mean survival of patients after 2 years of follow up was 53%. Organomegaly, lymphomadenopathy, the underlying disease and serum LDH were important prognostic factors and the most frequent complication of DHAP regimen was neutropenia [55%]. Having acceptable complications, the DHAP regimen was proved to be effective for patients with relapsed or refractory lymphoma. For stronger recommendation of this regimen larger scale trials are needed