Efficacy and Safety of Modified Rituximab-ESHAP Therapy for Relapsed/Refractory B-Cell Lymphoma

• Published in: Journal of chemotherapy (Florence) 2010-02, Vol.22 (1), p.54-57
• Main Authors: Ueda, K., Nannya, Y., Asai, T., Yamamoto, G., Hangaishi, A., Takahashi, T., Imai, Y., Kurokawa, M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - adverse effects; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; carboplatin; cisplatin; Cisplatin - administration & dosage; Cisplatin - adverse effects; Cytarabine - administration & dosage; Cytarabine - adverse effects; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Etoposide - administration & dosage; Etoposide - adverse effects; Female; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Mobilization; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell - drug therapy; Lymphoma, B-Cell - mortality; Male; Medical sciences; Middle Aged; non-Hodgkin lymphoma; Pharmacology. Drug treatments; Recurrence; Rituximab; salvage therapy
• ISSN: 1120-009X; 1973-9478
• DOI: 10.1179/joc.2010.22.1.54

Combined therapy of rituximab, etoposide, methylprednisolone, high-dose cytarabine, and cisplatin (R-ESHAP) has been one of the most frequently used salvage regimens for relapsed/refractory non-Hodgkin's lymphoma. In 2002, we introduced the modified R-ESHAP regimen in which cisplatin was switched to carboplatin. We evaluated the safety and effectiveness of this modified regimen by reviewing the records of 35 patients who had been administered R-ESHAP. Our cohort included 21 patients with diffuse large b cell lymphoma (DLBCL) and 14 patients with follicular lymphoma (FL). The overall response rate (ORR) was 48% for DLBCL and 93% for FL. The overall survival (OS) for patients with DLBCL was 51% with a median follow-up of 11 months, and 91% for patients with FL with a median follow-up of 36 months. Our study indicates that modified R-ESHAP is an effective and safe salvage regimen for relapsed/refractory FL, however, its efficacy for relapsed DLBCL is limited.