Barton, S., Hawkes, E. A., Cunningham, D., Peckitt, C., Chua, S., Wotherspoon, A., Attygalle, A., Horwich, A., Potter, M., Ethell, M., Dearden, C., Gleeson, M., Chau, I. (2015) Rituximab, Gemcitabine, Cisplatin and Methylprednisolone (R-GEM-P) is an effective regimen in relapsed diffuse large B-cell lymphoma. EUROPEAN JOURNAL OF HAEMATOLOGY, 94 (3). pp. 219-226. ISSN 0902-4441

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Abstract

BackgroundPatients with relapsed diffuse large B-cell lymphoma (DLBCL) have a poor prognosis. Gemcitabine, methylprednisolone, cisplatin +/- rituximab (GEM-P+/-R) is a salvage regimen with limited overlap in toxicity with first-line therapy and short duration of inpatient delivery. MethodsWe assessed the efficacy and safety of GEM-P+/-R in a retrospective single-centre analysis including patients meeting criteria of 18yr of age, histologically proven DLBCL, treated between 2001 and 2011 in second-line with gemcitabine 1000mg/m(2) day 1, 8 and 15, methylprednisolone 1000mg day 1-5, cisplatin 100mg/m(2) day 15 (replaced with carboplatin AUC5 if contraindication/toxicity) +/- rituximab 375mg/m(2) day 1 and 15, every 28d. ResultsForty-five patients aged 25-74 received a median of three cycles of GEM-P+/-R; 64% received rituximab. In 44 evaluable patients receiving GEM-P+/-R, overall response rate (ORR) was 48%; in 28 evaluable patients treated with rituximab + GEM-P (R-GEM-P), ORR was 61%. With median follow-up of 50.5months (95% CI: 28.3-72.7), 3-yr overall survival (OS) from start of GEM-P+/-R was 31.4% (95% CI: 16.5-46.3); in patients treated with R-GEM-P, 3-yr OS was 49.1% (95% CI: 28.7-69.5). Predominant grade3 toxicities were haematological; thrombocytopenia 69%, neutropenia 60% and febrile neutropenia 7%. ConclusionR-GEM-P is a deliverable regimen with useful activity in second-line treatment of DLBCL. Our data suggest that rituximab should be given concurrently.

Item Type:	Article
Authors (ICR Faculty only):	Cunningham, David and Horwich, Alan and chau, ian
All Authors:	Barton, S., Hawkes, E. A., Cunningham, D., Peckitt, C., Chua, S., Wotherspoon, A., Attygalle, A., Horwich, A., Potter, M., Ethell, M., Dearden, C., Gleeson, M., Chau, I.
Additional Information:	ISI Document Delivery No.: CC4XE Times Cited: 0 Cited Reference Count: 37 Barton, Sarah Hawkes, Eliza A. Cunningham, David Peckitt, Clare Chua, Sue Wotherspoon, Andrew Attygalle, Ayoma Horwich, Alan Potter, Mike Ethell, Mark Dearden, Claire Gleeson, Mary Chau, Ian National Health Service (NHS); Institute of Cancer Research, London, UK The authors acknowledge National Health Service (NHS) funding to the National Institute for Health Research Biomedical Research Centre at the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK. 0 WILEY-BLACKWELL HOBOKEN EUR J HAEMATOL
Uncontrolled Keywords:	lymphoma large B-cell diffuse gemcitabine cisplatin rituximab relapse NON-HODGKINS-LYMPHOMA POSITRON-EMISSION-TOMOGRAPHY INTERNATIONAL WORKSHOP CRITERIA EFFECTIVE SALVAGE REGIMEN MULTICENTER PHASE-II RESPONSE ASSESSMENT ELDERLY-PATIENTS PLUS RITUXIMAB LENALIDOMIDE MONOTHERAPY MARROW TRANSPLANTATION Hematology
Research teams:	Clinical Units > Gastrointestinal Unit Clinical Units > Gynaecology Unit ICR divisions > Radiotherapy and Imaging > Clinical Academic Radiotherapy (Horwich)
Depositing User:	Users 11 not found.
Date Deposited:	10 Apr 2015 10:42
Last Modified:	10 Apr 2015 10:42
URI:	http://publications.icr.ac.uk/id/eprint/14016

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