title: A salvage chemotherapy of R-P-IMVP16/CBDCA consisting of rituximab, methylprednisolone, ifosfamide, methotrexate, etoposide, and carboplatin for patients with diffuse large B cell lymphoma who had previously received R-CHOP therapy as first-line chemotherapy.
abstract: We have reported the efficacy of the salvage chemotherapy P-IMVP16/CBDCA for patients with diffuse large B cell lymphoma (DLBCL) who had previously received CHOP before the availability of rituximab (R). Here, we confirmed the efficacy of R combined with P-IMVP16/CBDCA as a salvage chemotherapy for patients with DLBCL, who had previously received R-CHOP. We retrospectively analysed 59 patients with relapse or refractory DLBCL (38 male patients and 21 female patients) presenting between June 2004 and June 2013. The patients received R 375 mg/m2on day 1, methylprednisolone 1000 mg/body for 3 days (from day 3 to day 5), ifosfamide 1000 mg/m2for 5 days (from day 3 to day 7), methotrexate 30 mg/m2on day 5 and day 12, etoposide 80 mg/m2for 3 days (from day 3 to day 5), and carboplatin 300 mg/m2on day 3 every 21 days. Patients aged 70 years or older were given 75% of the standard dose. The overall response rate (complete response + partial response) was 64.4%. The 2-year overall survival rate was 55.3%. The 2-year progression free survival rate was 34.7%. The 2-year overall survival rate was 61.5% for the relapse patients, and 15.6% for the refractory patients (p < 0.0001). One patient died because of sepsis related to the treatment regimen. Non-hematological adverse effects were mild and tolerable. The R-P-IMVP-16/CBDCA regimen displayed a significant activity in relapsed DLBCL, with acceptable toxicity, and should be considered a candidate for salvage chemotherapy. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Soranobu
authors.initials: S
authors.lastname: Ninomiya
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Kitagawa
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kanemura
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Naoe
authors.initials: N
authors.lastname: Goto
authors.affiliation: Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kito
authors.affiliation: Department of Hematology, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: Senji
authors.initials: S
authors.lastname: Kasahara
authors.affiliation: Department of Hematology, Gifu Prefectural General Medical Center, Gifu, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Hematology, Japanese Red Cross Gifu Hospital, Gifu, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Sawada
authors.affiliation: Pathology Division, Gifu University Hospital, Gifu, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takami
authors.affiliation: Department of Pathology and Translational Research, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
authors.affiliation: Department of Hematology, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsurumi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide; D004317:Doxorubicin; D005047:Etoposide / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects / Q000627:therapeutic use; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone; D011379:Prognosis; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D000069283:Rituximab; D016879:Salvage Therapy; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014750:Vincristine
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D007069:Ifosfamide; D011241:Prednisone; D008727:Methotrexate
keywords: diffuse large B cell lymphoma; rituximab; salvage chemotherapy