title: Gemcitabine, cisplatin and methylprednisolone (GEM-P) is an effective salvage regimen in patients with relapsed and refractory lymphoma.
abstract: There is currently no standard salvage chemotherapy regimen in relapsed and refractory lymphoma. Gemcitabine is a novel nucleoside analogue, which acts synergistically with cisplatin both in vitro and in clinical studies. We evaluated the combination of gemcitabine, cisplatin and methylprednisolone (GEM-P) in 41 heavily pretreated patients with relapsed and refractory Hodgkin's and non-Hodgkin's lymphoma. The best-achieved response rate (RR) was 79% (95% CI 64-91), with a complete RR of 21%. In patients with chemo-resistant disease, the RR was 63%. Myelosuppression was the main toxicity, the incidence of Grade 3 or 4 anaemia, neutropenia and thrombocytopenia was 17.1, 61.0 and 53.7% respectively. Only one patient had neutropenic sepsis and none of the patients suffered from haemorrhage. Grade 3 or 4 nonhaematological toxicity was minimal and stem cell mobilisation was not inhibited. GEM-P is an effective salvage regimen and its use prior to autologous stem cell transplant warrants further investigation.
authors.affiliation: Department of Medicine, Royal Marsden Hospital, Surrey, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ng
authors.forename: J
authors.initials: J
authors.lastname: Waters
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
authors.forename: I
authors.initials: I
authors.lastname: Chau
authors.forename: A
authors.initials: A
authors.lastname: Horwich
authors.forename: M
authors.initials: M
authors.lastname: Hill
authors.forename: A R
authors.initials: AR
authors.lastname: Norman
authors.forename: A
authors.initials: A
authors.lastname: Wotherspoon
authors.forename: D
authors.initials: D
authors.lastname: Catovsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000401:mortality; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D008775:Methylprednisolone; D000093542:Gemcitabine