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- Title
ESHAP as Salvage Therapy for Refractory Non-Hodgkin's Lymphoma: Taiwan Experience.
- Authors
Wang, Wei-Shu; Chiou, Tzeon-Jye; Liu, Jin-Hwang; Fan, Frank S; Yen, Chueh-Chuan; Tung, Shiao-Lin; Chen, Po-Min
- Abstract
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 <1000/µl) lasted for an average of 12 days and thrombocytopenia (<25 000/µl) 18 days. One patient (3.1 %) died of neutropenia-associated sepsis within 4 weeks after treatment. Non-myeloid toxicities included alopecia in 66% (28% grade 2, 22% grade 3), stomatitis in 72% (25% grade 2,28% grade 3,13% grade 4), hepatotoxicity in 9% (3% grade 2), renal toxicity in 13% (6% grade 2, 3% grade 3) and infection in 56% (18% grade 2, 25% grade 3,13% grade 4). The majority of the responders relapsed within 2 years after ESHAP treatment. Median survival for all patients was 8.6 months.Conclusions: ESHAP is an active and tolerable regimen in Chinese patients with relapsed/refractory lymphoma, but the duration of remission is brief and without significant impact on survival.
- Publication
Japanese Journal of Clinical Oncology, 1999, Vol 29, Issue 1, p33
- ISSN
0368-2811
- Publication type
Article
- DOI
10.1093/jjco/29.1.33