title: Rituximab, Ara-C, dexamethasone and oxaliplatin is safe and active in heavily pretreated patients with diffuse large B-cell lymphoma.
abstract: OBJECTIVE
  Patients with relapsed diffuse large B-cell lymphoma (DLBCL) who are either not suitable for stem cell transplantation or suffer from relapsed disease after standard second-line chemotherapy face a dismal prognosis. Most of them have a reduced performance status and do not tolerate intensive chemotherapy.
  
  
  METHODS
  Twenty patients with relapsed DLBCL were given rituximab 375 mg/m(2) intravenously on day 1, Ara-C 2 x 1,000 mg intravenously on day 2, dexamethasone 40 mg intravenously on days 1-4, and oxaliplatin 130 mg/m(2) intravenously over 2 h on day 3 (R-ADOx).
  
  
  RESULTS
  Five patients (25%) achieved a complete remission, 9 (45%) had a partial response , 2 (10%) had stable disease with improvement in performance status, while 4 patients (20%) progressed. The median survival was 11 months (range 1-13). Despite extensive pretreatment, side effects were relatively mild and consisted of thrombocytopenia WHO grade III in 9 (45%) and grade IV in 2 (11%) patients, leukocytopenia WHO grade III in 10 (50%) cases (with infectious episodes in 2 patients), and transient peripheral neuropathy in 9 (45%) patients.
  
  
  CONCLUSIONS
  R-ADOx is well tolerated in heavily pretreated patients with an impaired performance status. In addition, it displays impressive therapeutic activity given the highly unfavorable patient characteristics and should be further investigated for treatment of DLBCL.
authors.affiliation: Division of Bone Marrow Transplantation, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Woehrer
authors.forename: Michael
authors.initials: M
authors.lastname: Hejna
authors.forename: Cathrin
authors.initials: C
authors.lastname: Skrabs
authors.forename: Johannes
authors.initials: J
authors.lastname: Drach
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jaeger
authors.forename: Markus
authors.initials: M
authors.lastname: Raderer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012189:Retrospective Studies; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000964:Antimetabolites, Antineoplastic; D009944:Organoplatinum Compounds; D003561:Cytarabine; D000077150:Oxaliplatin; D000069283:Rituximab; D003907:Dexamethasone