Rituximab and ESHAP as Second-line Therapy for Relapsed or Primary Refractory Diffuse Large B Cell Lymphoma: The Experience of a Single Center in Korea

ABSTRACT

BACKGROUND: The remission status prior to autologous stem cell transplantation (ASCT) influences the transplantation outcome in patients with relapsed or primary refractory diffuse large B cell lymphoma (DLBCL), a complete response (CR) generally being more favorable than a partial response (PR). This study investigated whether the addition of rituximab to the ESHAP chemotherapy regimen (R-ESHAP) could improve the CR rate in patients with relapsed or primary refractory DLBCL. METHODS: Retrospective analysis was performed with DLBCL registry data. RESULTS: Sixteen patients who had previously received one course of chemotherapy were administered R-ESHAP (median 3 cycles; range 1~6). The overall response rate of 75% (CR=50%; PR=25%), was significantly better than that achieved with ESHAP alone in 13 historical controls (31%; P=0.027). The toxicity was tolerable, with two febrile neutropenia episodes in 51 treatment cycles. Seven of the 12 responders to R-ESHAP underwent ASCT with BEAM. After a median follow-up of 17 months, the median survival endpoints have not been reached. CONCLUSION: R-ESHAP appears to induce high CR rates in relapsed or refractory DLBCL with acceptable toxicity.