Source: Cancer  |  Posted 10 years ago

Dexamethasone combined with high-dose cytarabine and oxaliplatin is active as salvage treatment for refractory or relapsed non-Hodgkin's lymphoma.

Researchers from the Institut du Cancer et d'Immunog?n?tique and other centres in France enrolled 15 patients who either failed to achieve complete responses with initial chemotherapy or who showed recurrent disease.

Patients received 40 mg dexamethasone daily (days 1 to 4), cytarabine (2000 mg/m? every 12 hours on day 2) and oxaliplatin 130 mg/m? on day 1. The cycle was repeated every 21 days. Patients received a median of four cycles.

Myelosuppression and transient sensory peripheral neuropathy emerged as the most common adverse events. However, serum creatinine did not increase in either patients with normal renal function or those with renal impairment before treatment.

Over the median follow-up of 17 months, eight patients (53 percent) showed complete responses, while three (20 percent) showed partial responses. Patients who responded suffered from various lymphomas, usually follicular.

Dexamethasone combined with high-dose cytarabine and oxaliplatin was active in patients who were resistant to previous chemotherapy as well as those who previously responded. None of the eight patients who showed complete responses relapsed after follow up, which lasted between four and twenty-four months.

Four patients who showed complete responses expressed molecular abnormalities on their tumour cells. In all four, these molecular markers disappeared.

The authors concluded that the toxicity of dexamethasone, high-dose cytarabine and oxaliplatin compares favourably with dexamethasone, cytarabine and cisplatin, a standard regimen for Hodgkin's lymphoma. They add that the combination of dexamethasone, high-dose cytarabine, and oxaliplatin appears to be a useful salvage therapy for refractory or relapsed non-Hodgkin's lymphoma and should be assessed in larger studies.