A multicenter phase II trial of etoposide, methylprednisolone, high-dose cytarabine, and oxaliplatin for patients with primary refractory/relapsed aggressive non-Hodgkin's lymphoma.
OBJECTIVE
We investigated the efficacy and toxicity of the etoposide, methylprednisolone, high-dose cytarabine, and oxaliplatin (ESHAOx), in which oxaliplatin (Ox) was substituted for cisplatin in the ESHAP [etoposide (E), methylprednisolone (S), high-dose cytarabine (HA), and cisplatin (P)] regimen, for patients with refractory/relapsed aggressive non-Hodgkin's lymphoma (NHL).


METHODS
The ESHAOx consisted of E (40 mg/m(2) on days 1-4), S (500 mg on days 1-5), HA (2 g/m(2) on day 5), and Ox (130 mg/m(2) on day 1) every 3 weeks to a maximum of six cycles. Responses were assessed every three cycles.


RESULTS
Twenty-seven patients were enrolled (19 with relapsed and 8 with refractory; 10 with an IPI score of 3-5). The overall response rate was 63% [95% confidence interval (95% CI) 45-81%], including eight complete remissions (CR) and one unconfirmed CR (33%). The median duration of response was 9.9 months (95% CI 5.7-14.2 months). After a median follow-up of 18.6 months, the median progression-free and overall survival was 5.3 months (95% CI 3.9-6.7 months) and 15.1 months (95% CI 9.4-20.9 months), respectively, with a 1-year survival rate of 61.5%. Most common grade 3/4 hematologic toxicities were neutropenia (56%) and thrombocytopenia (35%), whereas no patient experienced grade 3/4 renal or neurotoxicity.


CONCLUSIONS
The efficacy and toxicity profiles suggested that the ESHAOx can be an alternative option for patients with refractory/relapsed aggressive NHL.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea.
Sun Jin
SJ
Sym
Dae Ho
DH
Lee
Hye Jin
HJ
Kang
Seung Hyun
SH
Nam
Ho Young
HY
Kim
Seok Jin
SJ
Kim
Hyeon Seok
HS
Eom
Won Seog
WS
Kim
Cheolwon
C
Suh
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012074:Remission Induction / Q000379:methods; D015996:Survival Rate
D009944:Organoplatinum Compounds; D003561:Cytarabine; D000077150:Oxaliplatin; D005047:Etoposide; D008775:Methylprednisolone