A new therapeutic approach in very refractory diffuse large B-cell lymphoma

• A. Avilés ^[1] ; M.-J.Nambo ^[2] ; N. Neri ^[2] ; S. Cleto ^[2] ; L. Silva ^[2]
  1. [1] Oncology Research Unit, Oncology Hospital, National Medical Center, IMSS, Avenida Cuauhtemoc 330, Colonia Doctores, ZIP 06725, Mexico, DF, Mexico
  2. [2] Hematology Department, Oncology Hospital, National Medical Center, IMSS, Mexico, DF, Mexico
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 5, 2020, págs. 703-707
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose Patients with diagnosis of diffuse large B-cell lymphoma, who relapse after stem cell transplant (SCT) or are no candidates to SCT, have a poor prognosis and no current treatment is available. Thus, we conduct a rotatory chemotherapy schedule that employed low doses of chemotherapy agents to assess efficacy and toxicity in this setting of patients; the end point was the improved outcome.

    Methods Retrospectively we revised an analysis of 461 patients who were treated with a low-doses regimen of cytotoxic agents, who were treated in a single institution, all patients has been treated with at least two salvage regimens, including SCT, > 18 years, performance status < 3, and that were informed about the possibility of severe toxicities,, were considered candidates to the study. They received a weekly rotatory scheme including low doses of cytotoxic agents during 2 years.

    Results Overall response rate was achieved in 314 patients (68%, 95% Confidence interval (CI) 59–76%) and complete response was achieved in 151 cases (32%, 95% CI 25–38%); actuarial curves at 10 years show that progression-free survival was 58% (95% CI 51–66%) and OS was 50% (95% CI 43–57%). Dose reduction was not necessary; toxicity was minimal and well controlled. No death related to acute or late toxicities has been observed.

    Conclusion Low doses of cytotoxic agents for continuous, prolonged periods, with minimal drug-free intervals, represent a novel, active, and easily tolerated approach to management of patients with DLBCL in a terminal phase and improved outcome.