Cancer Chemotherapy and Pharmacology

, Volume 62, Issue 2, pp 299–304

Irinotecan plus cisplatin and dexamethasone (ICD) combination chemotherapy for patients with diffuse large B-cell lymphoma previously treated with Rituximab plus CHOP

Authors

  • Hye Jin Kang
    • Division of Hematology–Oncology, Department of Internal MedicineKorea Cancer Center Hospital
  • Won Seog Kim
    • Division of Hematology–Oncology, Department of Internal Medicine, Samsung Medical CenterSungkyunkwan University School of Medicine
  • Cheolwon Suh
    • Division of Oncology, Department of Internal Medicine, Asan Medical CenterUlsan University College of Medicine
  • Yeon Hee Park
    • Division of Hematology–Oncology, Department of Internal Medicine, Samsung Medical CenterSungkyunkwan University School of Medicine
  • Bong Seog Kim
    • Division of Hematology–Oncology, Department of Internal MedicineSeoul Veterans Hospital
  • Young Jin Yuh
    • Division of Hematology–Oncology, Department of Internal MedicineInje University Sanggye Paik Hospital
    • Division of Hematology–Oncology, Department of Internal MedicineKorea Cancer Center Hospital
Original Article

DOI: 10.1007/s00280-007-0607-4

Cite this article as:
Kang, H.J., Kim, W.S., Suh, C. et al. Cancer Chemother Pharmacol (2008) 62: 299. doi:10.1007/s00280-007-0607-4

Abstract

Purpose

The therapeutic strategy for relapsed or refractory patients with diffuse large B-cell lymphoma (DLBL) remains challenging yet. Salvage therapy has been tried for these patients according to their clinical status. We studied ICD (irinotecan, cisplatin and dexamethasone) regimen as salvage chemotherapy for DLBL patients previously treated with RCHOP.

Methods

Between February 2005 and May 2006, 15 patients were treated prospectively with ICD chemotherapy; irinotecan 65 mg/m2/day on days 1 and 8, cisplatin 30 mg/m2/day on days 1 and 8, and dexamethasone 40 mg/day on days 1–2 and 8–9. This schedule was planned to repeat every 3 weeks until disease progression, severe toxicity or stem cell transplantation.

Results

Of the 14 patients evaluable for response, 3 patients achieved CR, 7 patients PR, with 1 SD and 3 PD; overall response rate 71% (10/14; 95% confidence interval, 47–95%). The median progression free survival (PFS) and event free survival (EFS) were 113 (range 21–493+) and 77 (range 21–324+) days, respectively. The median overall survival was 267 (range 31–493+) days. Grade 3/4 neutropenia and grade 3 neutropenic fever were observed in 67% (22/33) and 18% (6/33) of cycles, respectively. There were 20% of grade 3/4 nausea and diarrhea observed.

Conclusions

The ICD regimen with current schedule showed high response rate for DLBL patients previously treated with RCHOP. But the high incidence of neutropenia led to delay of subsequent cycles causing dose intensity reduced, which seems to be related with short PFS and EFS.

Keywords

Diffuse large B-cell lymphomaIrinotecanCisplatinSalvage chemotherapy

Copyright information

© Springer-Verlag 2007