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- Title
Ruxolitinib combined with doxorubicin, etoposide, and dexamethasone for the treatment of the lymphoma-associated hemophagocytic syndrome.
- Authors
Zhou, Lanlan; Liu, Yanan; Wen, Zhenzhen; Yang, Shimei; Li, Mingjie; Zhu, Qiuhua; Qiu, Shiqiu; Gao, Yanmin; Wang, Hong; Yuan, Yuemei; Zhang, Hanling; Chen, Chaolun; Zeng, Wenbin; Guan, Zebing; Pan, Xueyi
- Abstract
Purpose: Case reports suggest that ruxolitinib-containing treatment could increase the clinical response rate of patients with hemophagocytic syndrome (HPS). This study aimed to explore the effect of ruxolitinib-containing treatment for patients with lymphoma-associated hemophagocytic syndrome (LAHS). Methods: This was a retrospective study of patients with LAHS hospitalized at the First Affiliated Hospital of Guangdong Pharmaceutical University between October 2017 and September 2019. Patients were treated with HLH-94 (etoposide and dexamethasone) or R-DED regimen (ruxolitinib, doxorubicin, etoposide, and dexamethasone). The clinical characteristics, treatment responses, and overall survival (OS) were compared. The patients were divided into the HLH-94 group (n = 34) and the R-DED group (n = 36). Results: Compared with HLH-94, R-DED might effectively improve the clinical manifestations, including fever and splenomegaly in patients with LAHS, and control the systemic cytokine storm. The response rate at 2 weeks was 54.8% in the HLH-94 group, which was lower than in the R-DED group (83.3%) (p = 0.011). The OS was significantly prolonged in the R-DED group compared with the HLH-94 group (median, 5 vs. 1.5 months, p = 0.003). The multivariable analysis showed that lower IL-10 levels [hazard ratio (HR)] = 1.000, [95% confidence interval (CI)] 1.000–1.000, p = 0.012), R-DED regimen (HR = 0.196, 95% CI 0.084–0.457, p < 0.001), and non-NK/T-cell lymphoma (HR = 0.254, 95% CI 0.102–0.628, p = 0.003) were associated with better OS. The prognosis of patients with LAHS was generally poor. Conclusion: Ruxolitinib can be combined with chemotherapy in HPS. It is feasible, with no early signals of increased toxicity.
- Subjects
CYTOKINE release syndrome; ETOPOSIDE; DEXAMETHASONE; TREATMENT effectiveness; SYNDROMES
- Publication
Journal of Cancer Research & Clinical Oncology, 2020, Vol 146, Issue 11, p3063
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-020-03301-y