[Efficacy of GDP regimen (gemcitabine, dexamethasone, and cisplatin) on relapsed or refractory aggressive non-Hodgkin's Lymphoma: a report of 24 cases].
OBJECTIVE
The prognosis of relapsed or refractory aggressive non-Hodgkin's lymphoma (NHL) after front-line therapy remains poor. The development of more effective and less toxic salvage regimens remains a major challenge. Gemcitabine is effective in treating lymphoma and, when combined with cisplatin, is effective for some solid tumors. This study was to evaluate the efficacy of GDP regimen (gemcitabine, dexamethasone, and cisplatin) on relapsed or refractory aggressive NHL, and observe the adverse events.


METHODS
Patients with relapsed or refractory aggressive NHL, measurable disease, and had received previously at least one chemotherapy regimen were enrolled and treated with GDP regimen (gemcitabine 1000 mg/m2 on Days 1 and 8, dexamethasone 20-40 mg on Days 1-3, and cisplatin 25 mg/m2 on Days 1-3) every 3 weeks. The efficacy and adverse events were evaluated according to the WHO criteria.


RESULTS
Twenty-four patients had received a total of 76 chemotherapy cycles, and were assessable for efficacy and adverse events. Five (20.8%) patients had complete response, 9 had partial response, 8 had stable disease, and 2 had progressive disease. The overall response rate (RR) was 58.3% for assessable patients; it was 57.1% for B-cell NHL patients and 60.0% for T-cell NHL patients (P=0.889). The median follow-up was 1.2 years. The 1-year overall survival rate was 41.7%; it was 42.9% in B-cell NHL patients and 40.0% in T-cell NHL patients (P=0.986). The occurrence rate was 37.5% for grade III/IV leucopenia, 25.0% for thrombocytopenia, and 16.7% for anemia in all patients. Non-hematologic toxicities were mild. There was no treatment-related death. Two patients proceeded to stem cell transplantation after salvage chemotherapy and obtained sufficient stem cells.


CONCLUSIONS
GDP regimen is an effective and relatively nontoxic salvage chemotherapy regimen for relapsed or refractory aggressive NHL.
Fan
Yun
Y
Department of Chemotherapy, Zhejiang Provincial Tumor Hospital, Hangzhou, Zhejiang, China. fanyun@csco.org.cn
Huang
Zhi-Yu
ZY
Luo
Lu-Hong
LH
Yu
Hai-Feng
HF
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D018432:Drug Resistance, Multiple; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012074:Remission Induction; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D015996:Survival Rate; D013921:Thrombocytopenia / Q000139:chemically induced; D055815:Young Adult
D003841:Deoxycytidine; D003907:Dexamethasone; D002945:Cisplatin