title: Salvage therapy with gemcitabine, ifosfamide, dexamethasone, and oxaliplatin (GIDOX) for B-cell non-Hodgkin's lymphoma: a consortium for improving survival of lymphoma (CISL) trial.
abstract: BACKGROUND
  We investigated response rates to and toxicities of gemcitabine, ifosfamide, dexamethasone, and oxaliplatin (GIDOX) for the treatment of relapsed or refractory aggressive B-cell non-Hodgkin lymphoma (NHL).
  
  
  METHODS
  Patients with recurrent or refractory diffuse large B-cell lymphoma or mantle cell lymphoma (DLBCL) were eligible for enrollment in this study. Treatment consisted of gemcitabine 1,000 mg/m(2) intravenously (i.v.) on Days 1 and 8, ifosfamide 2,000 mg/m(2) i.v. on Day 1, dexamethasone 40 mg orally on Days 1-4, and oxaliplatin 130 mg/m(2) i.v. on Day 2, every 21 days. The primary goal of treatment was to establish a response rate after three cycles. Afterwards, patients could proceed to high-dose chemotherapy followed by autologous stem cell transplantation (HDC-ASCT) or receive up to six treatment cycles.
  
  
  RESULTS
  Twenty-seven eligible patients were evaluated for toxicity and response. The median age of the patients was 54 years (range, 18-75 years), and most had DLBCL. After three cycles, there were four CR (15%) and 10 PR (37%) for an overall response rate (RR) of 52%. Among a total of 88 GIDOX cycles, grade 3 and 4 neutropenia occurred in 33% and 16% of the cycles, respectively. Likewise, grade 3 and 4 thrombocytopenia occurred in 14% and 16% of the cycles, respectively. Two patients (2%) experienced febrile neutropenia, while seven patients (26%) proceeded to HDC-ASCT.
  
  
  CONCLUSIONS
  GIDOX is an active salvage regimen for aggressive B-cell NHL and can be tolerated by patients with acceptable toxicity.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
authors.forename: Byeong-Bae
authors.initials: BB
authors.lastname: Park
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Eom
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Young Yiul
authors.initials: YY
authors.lastname: Lee
authors.forename: Suk Joong
authors.initials: SJ
authors.lastname: Oh
authors.forename: Dae Ho
authors.initials: DH
authors.lastname: Lee
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000473:pathology*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077150:Oxaliplatin; D016879:Salvage Therapy; D016896:Treatment Outcome; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D003907:Dexamethasone; D007069:Ifosfamide; D000093542:Gemcitabine