Abstract
Purpose
Hemophagocytic lymphohistiocytosis (HLH), especially lymphoma-associated HLH (LA-HLH), is a refractory immune disorder with high mortality. There is still no consensus regarding the ideal treatment for LA-HLH.
Methods
We performed a prospective multicenter study (NCT 04077905) to explore the efficacy of a modified DEP regimen as induction therapy for LA-HLH. Twenty-eight patients from 6 clinical centers in China were enrolled between September 2019 and July 2021. We evaluated the efficacy of the modified DEP induction therapy 4 weeks after the initiation of treatment.
Results
The results showed that the overall response rate was 89.3% (25/28 patients), whereby 28.6% (8/28 patients) achieved a complete response and 60.7% (17/28 patients) were in partial response. Ferritin and soluble CD25 levels were decreased significantly 4 weeks after the modified DEP induction therapy (P = 0.001 and P = 0.00016, respectively), while platelet count and total bilirubin improved significantly (P = 0.004 and P = 0.001, respectively). The 1-year overall survival rate of all patients was 34.5%, with a median survival of 6.5 months (range 0.5–19 months). Patients with LA-HLH who underwent a stem cell transplantation had a significantly better prognosis than those not achieving complete response 4 weeks after modified DEP induction therapy (P = 0.034).
Conclusion
Our study suggests that the modified DEP regimen is a safe and effective induction therapy for LA-HLH. Timely stem cell transplantation can improve the prognosis of patients with LA-HLH.
Trail registry number
NCT 04077905. URL: https://clinicaltrials.gov/ct2/show/NCT04077905?id=NCT04077905&draw=2&rank=1.
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Data availability
All the data are available from the corresponding author upon reasonable request.
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Acknowledgements
We thank the patients who participated in this trial and the members of the Chinese Hemophagocytic Lymphohistiocytosis Group.
Funding
This work was supported by the National Natural Science Foundation of China (no. 81871633), Beijing Natural Science Foundation (no. 7181003), and Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20180101). The funding body did not contribute to this study with respect to the design, data analysis, and/or writing of the manuscript.
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All the authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by YP. The first draft of the manuscript was written by YP and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.
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This study was approved by the Ethics Committee of Beijing Friendship Hospital.
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Pi, Y., Wang, J., Zhou, H. et al. Modified DEP regimen as induction therapy for lymphoma-associated hemophagocytic lymphohistiocytosis: a prospective, multicenter study. J Cancer Res Clin Oncol 149, 3033–3041 (2023). https://doi.org/10.1007/s00432-022-04157-0
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DOI: https://doi.org/10.1007/s00432-022-04157-0