Dexamethasone, oxaliplatin and cytarabine (R-DHAOx) as salvage and stem cells mobilizing therapy in relapsed/refractory diffuse large B cell lymphomas

Leuk Lymphoma. 2020 Jan;61(1):84-90. doi: 10.1080/10428194.2019.1658102. Epub 2019 Sep 4.

Abstract

Cisplatin-containing salvage regimens followed by autologous hematopoietic stem cell (HSC) transplantation are the current standard of care for relapsed or refractory (R/R) lymphomas. We retrospectively analyzed efficacy and stem cell mobilizing activity of oxaliplatin, cytarabine, dexamethasone and rituximab (R-DHAOx) in 53 R/R diffuse large B cell lymphomas (DLBCL) treated in our center (median lines 2, range 2-5; median age 59, range 22-79). Hematological toxicity was manageable and no patients experienced renal impairment. After 2 courses the overall response rate was 60% (CR 49%, PR 11%). Median overall survival (OS) was 30.53 months (95% CI 11.5-49.55), 3-year OS 40.5%. Twenty-two eligible patients collected HSC and transplantation was performed in 21/22 patients (95%), after a median of 52 days from last cycle. Our results suggest that in DLBCL R-DHAOx has an excellent stem cell mobilizing capability, response rate comparable to cisplatin-containing regimens and good toxicity profile.

Keywords: Oxaliplatin; refractory/relapsed diffuse large B cell lymphoma; salvage; stem cell mobilization.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cytarabine* / therapeutic use
  • Dexamethasone* / therapeutic use
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Oxaliplatin* / therapeutic use
  • Retrospective Studies
  • Rituximab / therapeutic use
  • Salvage Therapy
  • Stem Cells
  • Treatment Outcome
  • Young Adult

Substances

  • Cytarabine
  • Oxaliplatin
  • Rituximab
  • Dexamethasone