|
|
 Previous Article | Table of Contents | Next Article 
Effective salvage therapy for lymphoma with cisplatin in combination with
high-dose Ara-C and dexamethasone (DHAP)
WS Velasquez, F Cabanillas, P Salvador, P McLaughlin, M Fridrik, S Tucker, S Jagannath, FB Hagemeister, JR Redman and F Swan
Department of Hematology, University of Texas System Cancer Center, M.D.
Anderson Hospital and Tumor Institute, Houston 77030.
Ninety patients with progressive recurrent lymphoma were treated with a
combination of cisplatin 100 mg/m2 intravenously (IV) by continuous
infusion over 24 hours, followed by cytosine arabinoside in two pulses each
at a dose of 2 g/m2 given 12 hours apart. Dexamethasone, 40 mg orally or
IV, was given on days 1 through 4. Vigorous hydration was reinforced by
routine use of mannitol. Treatments were repeated at 3- to 4-week intervals
for six to ten courses. Most patients had not achieved complete remission
(CR) with prior therapies, which included Adriamycin (all patients) and
methotrexate and VP-16 (58 patients). Median patient age was 55 years.
Intermediate-grade lymphoma was the most frequent pathologic diagnosis.
Seven patients died within two weeks of therapy; of the remaining 83
patients, 28 (34%) or 31% if all patients are considered, achieved CR, and
22 (26.5%) achieved partial remission (PR). Response was evident after the
first two cycles of chemotherapy and appeared to be independent of the
histopathologic type of lymphoma. To date, only eight of the complete
responders have relapsed at a median follow-up of 11 months. The overall
2-year survival in 25%. Further analysis showed that patients with low
tumor burden and normal lactic acid dehydrogenase (LDH) had a high CR
response rate (67%) and a survival rate of 61% at 2 years. In contrast,
patients with both high tumor burden and elevated serum LDH levels had a
negligible CR rate, and only 5% are surviving at 1 year. Patients with
either high tumor burden with normal LDH or low tumor burden with elevated
LDH had an intermediate survival. Myelosuppression-related infection was
the most frequent serious complication of this regimen (31%) and the cause
of death of ten patients. Acute lysis syndrome was also observed in five
patients with high tumor burden and was the cause of death in three of
these patients. DHAP has proven to be an effective non-crossresistant
regimen for patients with relapsing or refractory lymphoma, particularly
for patients who have favorable prognostic characteristics.
Volume 71,
Issue 1,
pp. 117-122,
01/01/1988
Copyright © 1988 by The American Society of Hematology
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
H. NISHIMORI, N. FUJII, Y. MAEDA, K.-I. MATSUOKA, K. TAKENAKA, K. SHINAGAWA, K. IKEDA, K. MATSUO, M. HARADA, and M. TANIMOTO
Efficacy and Feasibility of IDEA Therapy for Refractory or Relapsed Non-Hodgkin's Lymphoma
Anticancer Res,
May 1, 2009;
29(5):
1749 - 1754.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Moreau, J. Klastersky, A. Schwarzbold, F. Muanza, A. Georgala, M. Aoun, A. Loizidou, M. Barette, S. Costantini, M. Delmelle, et al.
A general chemotherapy myelotoxicity score to predict febrile neutropenia in hematological malignancies
Ann. Onc.,
March 1, 2009;
20(3):
513 - 519.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B.-S. Kim, D.-W. Kim, S.-A. Im, C. W. Kim, T.-Y. Kim, S.-S. Yoon, D. S. Heo, Y.-J. Bang, S. Park, B. K. Kim, et al.
Effective second-line chemotherapy for extranodal NK/T-cell lymphoma consisting of etoposide, ifosfamide, methotrexate, and prednisolone
Ann. Onc.,
January 1, 2009;
20(1):
121 - 128.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Martin, E. Conde, M. Arnan, M. A. Canales, G. Deben, J. M. Sancho, R. Andreu, A. Salar, P. Garcia-Sanchez, L. Vazquez, et al.
R-ESHAP as salvage therapy for patients with relapsed or refractory diffuse large B-cell lymphoma: the influence of prior exposure to rituximab on outcome. A GEL/TAMO study
Haematologica,
December 1, 2008;
93(12):
1829 - 1836.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. W Tuffaha, I. M Treish, and L. Zaru
The use and effectiveness of granulocyte colony-stimulating factor in primary prophylaxis for febrile neutropenia in the outpatient setting
Journal of Oncology Pharmacy Practice,
September 1, 2008;
14(3):
131 - 138.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. Sebban, P. Brice, R. Delarue, C. Haioun, B. Souleau, N. Mounier, N. Brousse, P. Feugier, H. Tilly, P. Solal-Celigny, et al.
Impact of Rituximab and/or High-Dose Therapy With Autotransplant at Time of Relapse in Patients With Follicular Lymphoma: A GELA Study
J. Clin. Oncol.,
July 20, 2008;
26(21):
3614 - 3620.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Vellenga, W. L. J. van Putten, M. B. van 't Veer, J. M. Zijlstra, W. E. Fibbe, M. H. J. van Oers, L. F. Verdonck, P. W. Wijermans, G. W. van Imhoff, P. J. Lugtenburg, et al.
Rituximab improves the treatment results of DHAP-VIM-DHAP and ASCT in relapsed/progressive aggressive CD20+ NHL: a prospective randomized HOVON trial
Blood,
January 15, 2008;
111(2):
537 - 543.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Tsimberidou, W. G. Wierda, W. Plunkett, R. Kurzrock, S. O'Brien, S. Wen, A. Ferrajoli, F. Ravandi-Kashani, G. Garcia-Manero, Z. Estrov, et al.
Phase I-II Study of Oxaliplatin, Fludarabine, Cytarabine, and Rituximab Combination Therapy in Patients With Richter's Syndrome or Fludarabine-Refractory Chronic Lymphocytic Leukemia
J. Clin. Oncol.,
January 10, 2008;
26(2):
196 - 203.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Le Gouill, P. Talmant, C. Touzeau, A. Moreau, R. Garand, N. Juge-Morineau, F. Gaillard, T. Gastinne, N. Milpied, P. Moreau, et al.
The clinical presentation and prognosis of diffuse large B-cell lymphoma with t(14;18) and 8q24/c-MYC rearrangement
Haematologica,
October 1, 2007;
92(10):
1335 - 1342.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Moufarij, D. Sampath, M. J. Keating, and W. Plunkett
Fludarabine increases oxaliplatin cytotoxicity in normal and chronic lymphocytic leukemia lymphocytes by suppressing interstrand DNA crosslink removal
Blood,
December 15, 2006;
108(13):
4187 - 4193.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. J. Smith, J. Khatcheressian, G. H. Lyman, H. Ozer, J. O. Armitage, L. Balducci, C. L. Bennett, S. B. Cantor, J. Crawford, S. J. Cross, et al.
2006 Update of Recommendations for the Use of White Blood Cell Growth Factors: An Evidence-Based Clinical Practice Guideline
J. Clin. Oncol.,
July 1, 2006;
24(19):
3187 - 3205.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Olivieri, G. Santini, C. Patti, T. Chisesi, C. De Souza, A. Rubagotti, S. Aversa, A. Billio, A. Porcellini, M. Candela, et al.
Upfront high-dose sequential therapy (HDS) versus VACOP-B with or without HDS in aggressive non-Hodgkin's lymphoma: long-term results by the NHLCSG
Ann. Onc.,
December 1, 2005;
16(12):
1941 - 1948.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Kewalramani, A. D. Zelenetz, S. D. Nimer, C. Portlock, D. Straus, A. Noy, O. O'Connor, D. A. Filippa, J. Teruya-Feldstein, A. Gencarelli, et al.
Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma
Blood,
May 15, 2004;
103(10):
3684 - 3688.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Feugier, J. M. Virion, H. Tilly, C. Haioun, G. Marit, M. Macro, D. Bordessoule, C. Recher, M. Blanc, T. Molina, et al.
Incidence and risk factors for central nervous system occurrence in elderly patients with diffuse large-B-cell lymphoma: influence of rituximab
Ann. Onc.,
January 1, 2004;
15(1):
129 - 133.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. A. Hamlin, A. D. Zelenetz, T. Kewalramani, J. Qin, J. M. Satagopan, D. Verbel, A. Noy, C. S. Portlock, D. J. Straus, J. Yahalom, et al.
Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma
Blood,
September 15, 2003;
102(6):
1989 - 1996.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.M. Vose, M. Crump, H. Lazarus, C. Emmanouilides, D. Schenkein, J. Moore, S. Frankel, I. Flinn, W. Lovelace, J. Hackett, et al.
Randomized, Multicenter, Open-Label Study of Pegfilgrastim Compared With Daily Filgrastim After Chemotherapy for Lymphoma
J. Clin. Oncol.,
February 1, 2003;
21(3):
514 - 519.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Tsimberidou, P. McLaughlin, A. Younes, M. A. Rodriguez, F. B. Hagemeister, A. Sarris, J. Romaguera, M. Hess, T. L. Smith, Y. Yang, et al.
Fludarabine, mitoxantrone, dexamethasone (FND) compared with an alternating triple therapy (ATT) regimen in patients with stage IV indolent lymphoma
Blood,
December 15, 2002;
100(13):
4351 - 4357.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Ladetto, P. Corradini, S. Vallet, F. Benedetti, U. Vitolo, M. Martelli, M. Brugiatelli, P. Coser, A. Perrotti, I. Majolino, et al.
High rate of clinical and molecular remissions in follicular lymphoma patients receiving high-dose sequential chemotherapy and autografting at diagnosis: a multicenter, prospective study by the Gruppo Italiano Trapianto Midollo Osseo (GITMO)
Blood,
August 13, 2002;
100(5):
1559 - 1565.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Visco, L. J. Medeiros, D. Jones, T. Smith, M. A. Rodriguez, P. McLaughlin, J. Romaguera, F. Cabanillas, and A. H. Sarris
Primary cutaneous non-Hodgkin's lymphoma with aggressive histology: inferior outcome is associated with peripheral T-cell type and elevated lactate dehydrogenase, but not extent of cutaneous involvement
Ann. Onc.,
August 1, 2002;
13(8):
1290 - 1299.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. J. Lowe and G. A. Wiseman
Assessment of Lymphoma Therapy Using 18F-FDG PET
J. Nucl. Med.,
August 1, 2002;
43(8):
1028 - 1030.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. A. Wiseman, L. I. Gordon, P. S. Multani, T. E. Witzig, S. Spies, N. L. Bartlett, R. J. Schilder, J. L. Murray, M. Saleh, R. S. Allen, et al.
Ibritumomab tiuxetan radioimmunotherapy for patients with relapsed or refractory non-Hodgkin lymphoma and mild thrombocytopenia: a phase II multicenter trial
Blood,
May 29, 2002;
99(12):
4336 - 4342.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Renz, W. E. Berdel, M. Kreuter, C. Belka, K. Schulze-Osthoff, and M. Los
Rapid extracellular release of cytochrome c is specific for apoptosis and marks cell death in vivo
Blood,
September 1, 2001;
98(5):
1542 - 1548.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. H. Sarris, I. Braunschweig, L. J. Medeiros, M. Duvic, C. S. Ha, M. A. Rodriguez, F. B. Hagemeister, P. McLaughlin, J. Romaguera, J. Cox, et al.
Primary Cutaneous Non-Hodgkin's Lymphoma of Ann Arbor Stage I: Preferential Cutaneous Relapses but High Cure Rate With Doxorubicin-Based Therapy
J. Clin. Oncol.,
January 15, 2001;
19(2):
398 - 405.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Vose, M.-J. Zhang, P. A. Rowlings, H. M. Lazarus, B. J. Bolwell, C. O. Freytes, S. Pavlovsky, A. Keating, B. Yanes, K. van Besien, et al.
Autologous Transplantation for Diffuse Aggressive Non-Hodgkin's Lymphoma in Patients Never Achieving Remission: A Report from the Autologous Blood and Marrow Transplant Registry
J. Clin. Oncol.,
January 15, 2001;
19(2):
406 - 413.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Gutierrez, B. A. Chabner, D. Pearson, S. M. Steinberg, E. S. Jaffe, B. D. Cheson, A. Fojo, and W. H. Wilson
Role of a Doxorubicin-Containing Regimen in Relapsed and Resistant Lymphomas: An 8-Year Follow-Up Study of EPOCH
J. Clin. Oncol.,
November 1, 2000;
18(21):
3633 - 3642.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Kewalramani, A. D. Zelenetz, E. E. Hedrick, G. B. Donnelly, S. Hunte, A. C. Priovolos, J. Qin, N. C. Lyons, J. Yahalom, S. D. Nimer, et al.
High-dose chemoradiotherapy and autologous stem cell transplantation for patients with primary refractory aggressive non-Hodgkin lymphoma: an intention-to-treat analysis
Blood,
October 1, 2000;
96(7):
2399 - 2404.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Magni, M. Di Nicola, L. Devizzi, P. Matteucci, F. Lombardi, L. Gandola, F. Ravagnani, R. Giardini, G. Dastoli, C. Tarella, et al.
Successful in vivo purging of CD34-containing peripheral blood harvests in mantle cell and indolent lymphoma: evidence for a role of both chemotherapy and rituximab infusion
Blood,
August 1, 2000;
96(3):
864 - 869.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. H. Moskowitz, J. R. Bertino, J. R. Glassman, E. E. Hedrick, S. Hunte, N. Coady-Lyons, D. B. Agus, A. Goy, J. Jurcic, A. Noy, et al.
Ifosfamide, Carboplatin, and Etoposide: A Highly Effective Cytoreduction and Peripheral-Blood Progenitor-Cell Mobilization Regimen for Transplant-Eligible Patients With Non-Hodgkin's Lymphoma
J. Clin. Oncol.,
December 1, 1999;
17(12):
3776 - 3785.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. W. Sweetenham, A. M. Carella, G. Taghipour, D. Cunningham, R. Marcus, A. D. Volpe, D. C. Linch, N. Schmitz, and A. H. Goldstone
High-Dose Therapy and Autologous Stem-Cell Transplantation for Adult Patients With Hodgkin's Disease Who Do Not Enter Remission After Induction Chemotherapy: Results in 175 Patients Reported to the European Group for Blood and Marrow Transplantation
J. Clin. Oncol.,
October 1, 1999;
17(10):
3101 - 3109.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-Y. Blay, F. Gomez, C. Sebban, T. Bachelot, P. Biron, C. Guglielmi, A. Hagenbeek, R. Somers, F. Chauvin, and T. Philip
The International Prognostic Index Correlates to Survival in Patients With Aggressive Lymphoma in Relapse: Analysis of the PARMA Trial
Blood,
November 15, 1998;
92(10):
3562 - 3568.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Coiffier, C. Haioun, N. Ketterer, A. Engert, H. Tilly, D. Ma, P. Johnson, A. Lister, M. F. Buske, J.A. Radford, et al.
Rituximab (Anti-CD20 Monoclonal Antibody) for the Treatment of Patients With Relapsing or Refractory Aggressive Lymphoma: A Multicenter Phase II Study
Blood,
September 15, 1998;
92(6):
1927 - 1932.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. H. Ottensmeier, A. R. Thompsett, D. Zhu, B. S. Wilkins, J. W. Sweetenham, and F. K. Stevenson
Analysis of VH Genes in Follicular and Diffuse Lymphoma Shows Ongoing Somatic Mutation and Multiple Isotype Transcripts in Early Disease With Changes During Disease Progression
Blood,
June 1, 1998;
91(11):
4292 - 4299.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. H. Sehn, J. H. Antin, L. N. Shulman, P. Mauch, A. Elias, M. E. Kadin, and C. Wheeler
Primary Diffuse Large B-Cell Lymphoma of the Mediastinum: Outcome Following High-Dose Chemotherapy and Autologous Hematopoietic Cell Transplantation
Blood,
January 15, 1998;
91(2):
717 - 723.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. L. E. M. Bollen, R. E. Brouwer, S. Hamers, J. Hermans, Ph. M. Kluin, S. U. C. Sankatsing, R. V. A-Tjak, M. V. Charvat, and J. C. Kluin-Nelemans
Central Nervous System Relapse in Non-Hodgkin Lymphoma: A Single-Center Study of 532 Patients
Arch Neurol,
July 1, 1997;
54(7):
854 - 859.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. R. Yuen, S. A. Rosenberg, R. T. Hoppe, J. D. Halpern, and S. J. Horning
Comparison Between Conventional Salvage Therapy and High-Dose Therapy With Autografting for Recurrent or Refractory Hodgkin's Disease
Blood,
February 1, 1997;
89(3):
814 - 822.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Philip, C. Guglielmi, A. Hagenbeek, R. Somers, H. Van Der Lelie, D. Bron, P. Sonneveld, C. Gisselbrecht, J.-Y. Cahn, J.-L. Harousseau, et al.
Autologous Bone Marrow Transplantation as Compared with Salvage Chemotherapy in Relapses of Chemotherapy-Sensitive Non-Hodgkin's Lymphoma
N. Engl. J. Med.,
December 7, 1995;
333(23):
1540 - 1545.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Vose
Treatment for Non-Hodgkin's Lymphoma in Relapse -- What Are the Alternatives?
N. Engl. J. Med.,
December 7, 1995;
333(23):
1565 - 1566.
[Full Text]
|
|
|
|
|
|
|
J. M. Vose, P. J. Bierman, and J. O. Armitage
Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF): Answers or More Questions?
Ann Intern Med,
February 1, 1992;
116(3):
261 - 262.
[Abstract]
[PDF]
|
|
|
|
|
