Literature DB >> 24158386

GEM-P chemotherapy is active in the treatment of relapsed Hodgkin lymphoma.

Eliza A Hawkes1, Sarah Barton, David Cunningham, Clare Peckitt, Sue Chua, Andrew Wotherspoon, Alan Horwich, Mike Potter, Mark Ethel, Claire Dearden, Ian Chau.   

Abstract

Hodgkin lymphoma (HL) is a relatively chemosensitive malignancy. However, for those who relapse, high-dose chemotherapy with autologous stem cell transplant is the treatment of choice which relies on adequate disease control with salvage chemotherapy. Regimens commonly used often require inpatient administration and can be difficult to deliver due to toxicity. Gemcitabine and cisplatin have activity in HL, non-overlapping toxicity with first-line chemotherapeutics, and may be delivered in an outpatient setting. In this retrospective single-centre analysis, patients with relapsed or refractory HL treated with gemcitabine 1,000 mg/m(2) day (D)1, D8 and D15; methylprednisolone 1,000 mg D1-5; and cisplatin 100 mg/m(2) D15, every 28 days (GEM-P) were included. Demographic, survival, response and toxicity data were recorded. Forty-one eligible patients were identified: median age 27. One hundred and twenty-two cycles of GEM-P were administered in total (median 3 cycles; range 1-6). Twenty of 41 (48 %) patients received GEM-P as second-line treatment and 11/41 (27 %) as third-line therapy. Overall response rate (ORR) to GEM-P in the entire cohort was 80 % (complete response (CR) 37 %, partial response 44 %) with 14/15 CR confirmed as a metabolic CR on PET and ORR of 85 % in the 20 second-line patients. The most common grade 3/4 toxicities were haematological: neutropenia 54 % and thrombocytopenia 51 %. Median follow-up from the start of GEM-P was 4.5 years. Following GEM-P, 5-year progression-free survival was 46 % (95 % confidence interval (CI), 30-62 %) and 5-year overall survival was 59 % (95 % CI, 43-74 %). Fourteen of 41 patients proceeded directly to autologous transplant. GEM-P is a salvage chemotherapy with relatively high response rates, leading to successful transplantation in appropriate patients, in the treatment of relapsed or refractory HL.

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Year:  2013        PMID: 24158386     DOI: 10.1007/s00277-013-1930-y

Source DB:  PubMed          Journal:  Ann Hematol        ISSN: 0939-5555            Impact factor:   3.673


  4 in total

1.  Stimulation of the hypoxia pathway modulates chemotherapy resistance in Hodgkin's lymphoma cells.

Authors:  Stefanie Kewitz; Lars Kurch; Ines Volkmer; Martin S Staege
Journal:  Tumour Biol       Date:  2015-12-30

Review 2.  The role of T cells in the microenvironment of Hodgkin lymphoma.

Authors:  Frederik Wein; Ralf Küppers
Journal:  J Leukoc Biol       Date:  2015-08-28       Impact factor: 4.962

3.  Patients with classical Hodgkin lymphoma experiencing disease progression after treatment with brentuximab vedotin have poor outcomes.

Authors:  C Y Cheah; D Chihara; S Horowitz; A Sevin; Y Oki; S Zhou; N H Fowler; J E Romaguera; F Turturro; F B Hagemeister; L E Fayad; M Wang; S S Neelapu; L J Nastoupil; J R Westin; M A Rodriguez; F Samaniego; P Anderlini; Y Nieto; M A Fanale
Journal:  Ann Oncol       Date:  2016-04-18       Impact factor: 32.976

Review 4.  Relapsed Hodgkin lymphoma: management strategies.

Authors:  Francesca Montanari; Catherine Diefenbach
Journal:  Curr Hematol Malig Rep       Date:  2014-09       Impact factor: 3.952

  4 in total

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