ESHAP as Salvage Therapy for Refractory Non-Hodgkin's Lymphoma: Taiwan Experience

Background: The ESHAP regimen, a combination of the chemotherapeutic drugs etoposide, methylprednisolone (solumedrol), high-dose cytarabine (ara-C) and cisplatin, has been shown to be active against refractory non-Hodgkin's lymphoma in therapeutic trials. We were interested in determining wheth...

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Bibliographic Details
Published in:Japanese journal of clinical oncology 1999-01, Vol.29 (1), p.33-37
Main Authors: Wang, Wei-Shu, Chiou, Tzeon-Jye, Liu, Jin-Hwang, Fan, Frank S, Yen, Chueh-Chuan, Tung, Shiao-Lin, Chen, Po-Min
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Cisplatin - administration & dosage
Cytarabine - administration & dosage
Drug Administration Schedule
ESHAP
Etoposide - administration & dosage
Female
Humans
Infusions, Intravenous
Lymphoma, Non-Hodgkin - drug therapy
Male
Methylprednisolone - administration & dosage
Middle Aged
Recurrence
refractory non-Hodgkin's lymphoma
Remission Induction
Salvage Therapy
Survival Analysis
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Summary:Background: The ESHAP regimen, a combination of the chemotherapeutic drugs etoposide, methylprednisolone (solumedrol), high-dose cytarabine (ara-C) and cisplatin, has been shown to be active against refractory non-Hodgkin's lymphoma in therapeutic trials. We were interested in determining whether this regimen would be effective and tolerable for Chinese patients. Methods: Thirty-two patients with refractory/relapsed non-Hodgkin's lymphoma (23 intermediategrade and nine high-grade) were enrolled in this study. Etoposide was administered at a dose of 40 mg/m2/day as a 1 h intravenous infusion from day 1 to day 4, solumedrol 500 mg/day was given as a 15 min intravenous infusion from day 1 to day 5, ara-C 2 g/m2 was given as a 2 h intravenous infusion on day 5 and cisplatin was given at a dose of 25 mg/m2/day as a continuous infusion from day 1 to day 4. Clinical efficacy and toxicity were assessed on the basis of the WHO criteria. Results: Ten patients (31.3%, 95% C115.2-47.4%) attained complete remission (CR) and seven had partial remission (PR). The overall response rate was 53.1% (95% CI 35.8–70.4%). In eight of the 10 CR patients, the remission lasted for more than 8 months. The remaining two patients had CR of 5 and 6 months. The median duration of CR was 12.2 months (range 5–22 months). Myelosuppression with subsequent infections was the major toxicity. Severe leukopenia (WBC
ISSN:0368-2811
1465-3621
DOI:10.1093/jjco/29.1.33