title: Modified Irinotecan Plus Cisplatin and Dexamethasone (ICD) Combination Chemotherapy as Salvage Chemotherapy for Patients with Relapsed/Refractory Diffuse Large Cell Lymphoma.
abstract: About 50 % of patients with diffuse large cell lymphoma are candidate for salvage chemotherapy followed by bone marrow transplantation in the selected patients. In the current study we evaluated modified ICD (Irinotecan, Cisplatin, and Dexamethasone with G-CSF support) as salvage chemotherapy in the patients previously treated with R-CHOP or CHOP. In a retrospective study we evaluated 16 patients treated with modified ICD: irinotecan 65 mg/m(2) (max 100 mg)/day plus cisplatin 30 mg/m(2) (max 50 mg)/day and dexamethasone 40 mg/day on days 1 and 8. Prednisolone 200 mg divided in 2 doses was given orally on days 2 and 9. G-CSF (PDgrastim) was administered at 300 μg/day subcutaneously on days 4-6 and 11-13. pre- and post-hydration was given according to our hospital protocol. Overall response rate was 75 % for all of the patients and 90 % for the patients treated as first line salvage. The median overall survival was 23 ± 12 months. There was no grade 3/4 of neutropenia and no cycles of chemotherapy were delayed due to leucopenia. Modified ICD might be an effective salvage regimen for refractory/relapsed lymphoma patients. Unlike original ICD, leucopenia does not seem to be a limiting factor. So we conclude that modified ICD shall be considered as a safe and effective regimen for salvage chemotherapy in refractory/relapsed patients.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Ghadiany
authors.affiliation: Department of Hematology and Oncology, Yazed University of Medical Science, Yazd, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Foratyazdi
authors.affiliation: Department of Hematology and Oncology, Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Rahimi
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Rezvani
authors.affiliation: Tehran, Iran.
authors.forename: Lila
authors.initials: L
authors.lastname: Sadeghi
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Abbas Haji
authors.initials: AH
authors.lastname: Fathali
keywords: Cisplatin; Diffuse large cell lymphoma; Irinotecan; Salvage chemotherapy