DHAP regimen plus G-CSF as salvage therapy and priming for blood progenitor cell collection in patients with poor prognosis lymphoma

Bone Marrow Transplant. 1995 Jul;16(1):85-93.

Abstract

We studied 14 patients affected by lymphoma to assess the toxicity, efficacy and mobilization capability of salvage DHAP regimen followed by G-CSF 5 micrograms/kg/day. Ten patients were affected by intermediate-grade NHL and 4 by HD; all of them were in relapse or in PR. We administered a total of 34 courses of DHAP plus G-CSF (median 2 per patient; range 1-5) and did not observe either life-threatening extrahematologic toxicity or severe infections during the short neutropenic period. A significant tumor burden reduction was observed in 86% of patients (50% CR, 36% PR). A total of 35 aphereses were performed (median 3 per patient; range 1-5). The hemopoietic progenitors showed a very rapid increase from day +11 with a synchronous and impressive peak on day +13. We collected a median of 2.6 x 10(6)/kg CD34+ cells, 10 x 10(4)/kg CFU-GM, 5 x 10(4)/kg BFU-E and 0.5 x 10(4)/kg CFU-GEMM per apheresis. All patients transplanted with PBPC had a rapid and sustained hematological recovery. The DHAP regimen followed by G-CSF proved to be a very effective and well-tolerated schedule for debulking disease before transplantation and for enhancing progenitor cell mobilization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cell Count
  • Cell Separation
  • Cisplatin / adverse effects
  • Cisplatin / therapeutic use
  • Combined Modality Therapy
  • Cytarabine / adverse effects
  • Cytarabine / therapeutic use
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use
  • Female
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Hematopoietic Stem Cell Transplantation*
  • Hematopoietic Stem Cells / pathology*
  • Humans
  • Leukapheresis
  • Lymphoma / pathology
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Prognosis
  • Salvage Therapy

Substances

  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Dexamethasone
  • Cisplatin

Supplementary concepts

  • DHAP protocol