title: Outcome for patients with relapsed/refractory aggressive lymphoma treated with gemcitabine and oxaliplatin with or without rituximab; a retrospective, multicentre study.
abstract: The treatment of relapsed aggressive lymphoma remains a challenge. Platinum-containing chemotherapy is standard of care. Gemcitabine/oxaliplatin (Gem-Ox) with or without rituximab (R) is an outpatient regimen with a favorable toxicity profile. This retrospective 'real world' study reports outcomes for 44 unselected patients with relapsed/refractory aggressive lymphoma treated with Gem-Ox ± R. 41% had primary refractory disease. The overall response rate (ORR) was 43% with a complete response (CR) of 30%. Response to the prior treatment regimen significantly affected the ORR with only 8% achieving CR if prior remission was <12 months. Grade 3-4 hematological toxicity was common and 22% had febrile neutropenia. Eight patients proceeded to stem cell transplant. Overall, outcomes remain poor with a median overall survival of 8 months. In this high-risk group of patients, Gem-Ox ± R results in similar responses to other more toxic, inpatient regimens and should therefore be considered as second line therapy in relapsed lymphoma.
authors.affiliation: a Department of Haematology , Medway Maritime Hospital , London , UK.
authors.forename: Vijay
authors.initials: V
authors.lastname: Dhanapal
authors.affiliation: a Department of Haematology , Medway Maritime Hospital , London , UK.
authors.forename: Menaka
authors.initials: M
authors.lastname: Gunasekara
authors.affiliation: a Department of Haematology , Medway Maritime Hospital , London , UK.
authors.forename: Chia
authors.initials: C
authors.lastname: Lianwea
authors.affiliation: b Department of Haematology , King's College Hospital , London , UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Marcus
authors.affiliation: b Department of Haematology , King's College Hospital , London , UK.
authors.forename: Corinne
authors.initials: C
authors.lastname: De Lord
authors.affiliation: b Department of Haematology , King's College Hospital , London , UK.
authors.forename: Stella
authors.initials: S
authors.lastname: Bowcock
authors.affiliation: b Department of Haematology , King's College Hospital , London , UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Devereux
authors.affiliation: b Department of Haematology , King's College Hospital , London , UK.
authors.forename: Piers
authors.initials: P
authors.lastname: Patten
authors.affiliation: b Department of Haematology , King's College Hospital , London , UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Yallop
authors.affiliation: c Department of Haematology , Guy's & St Thomas' Hospital , London , UK.
authors.forename: David
authors.initials: D
authors.lastname: Wrench
authors.affiliation: c Department of Haematology , Guy's & St Thomas' Hospital , London , UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Fields
authors.affiliation: b Department of Haematology , King's College Hospital , London , UK.
authors.forename: Shireen
authors.initials: S
authors.lastname: Kassam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D000072078:Positron Emission Tomography Computed Tomography; D012008:Recurrence; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069283:Rituximab; D000093542:Gemcitabine
keywords: Gemcitabine; oxaliplatin; relapsed lymphoma