Medicana International Ankara Hospital, Department of Hematology, Ankara, Turkey
Ayla Gokmen , Ender Soydan , Zafer Gokgoz , Mevlude Kurdal , Ibrahim Tek , Osman Ilhan , Onder Arslan , Muhit Ozcan
Background: The best combination chemotherapy as a salvage and mobilization regimen in patients with relapsed or refractory Hodgkin lymphoma ( HL) remains unknown. We retrospectively analysed the efficacy and safety of gemcitabine, dexamethasone and cisplatin (GDP) combination chemotherapy in patients with relapsed and refractory HL. Methods: 30 patients (18 male and 12 female patients) with relapsed or refractory HL who were treated with GDP as salvage and mobilization regimen before autologous stem cell transplantation bettween 2013-2017 in our center were included. Median age was 30 ( ranges 15-63). Eight patients had refractory (previous treatment cyles: 2-6), 22 patients had relapsed disease before treatment with GDP. All patients received at least 2 cyles of salvage chemotherapy. GDP regimen consisted of gemcitabine 1000 mg/ m2 /day on days 1 and 8, cisplatin 75 mg/ m2 /day on day 1 and dexamethasone 40 mg/ d on day 1-4. Results: Neither febrile neutropenic episode nor any other toxicities that necessitated treatment delay was observed. Overall response rate (ORR) was 73 %. Eleven ( 36.6%) patients achieved complete remission ( CR), 11 (36.6%) partial remission (PR) and 8 (26.6%) patients had stable disease. Stem cell mobilization was started after the second cyle of GDP with G-CSF 10 mcg/kg. Stem cell collection was achieved in all patients (%100) with a median 13.4x106 /kgCD 34 + cells ( ranges 3.0-59.0). All patients underwent autologous stem cell transplantation successfully with expected engraftment kinetics. We did not observed febrile neutropenic episode or any other dose limiting toxicities. Conclusions: GDP is an effective and safe outpatient salvage regimen in in patients with relapsed or refractory HL. The treatment can be given as an outpatient basis which may takes huge advantage in this setting.
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