Abstract
Purpose
Patients with diagnosis of diffuse large B-cell lymphoma, who relapse after stem cell transplant (SCT) or are no candidates to SCT, have a poor prognosis and no current treatment is available. Thus, we conduct a rotatory chemotherapy schedule that employed low doses of chemotherapy agents to assess efficacy and toxicity in this setting of patients; the end point was the improved outcome.
Methods
Retrospectively we revised an analysis of 461 patients who were treated with a low-doses regimen of cytotoxic agents, who were treated in a single institution, all patients has been treated with at least two salvage regimens, including SCT, > 18 years, performance status < 3, and that were informed about the possibility of severe toxicities,, were considered candidates to the study. They received a weekly rotatory scheme including low doses of cytotoxic agents during 2 years.
Results
Overall response rate was achieved in 314 patients (68%, 95% Confidence interval (CI) 59–76%) and complete response was achieved in 151 cases (32%, 95% CI 25–38%); actuarial curves at 10 years show that progression-free survival was 58% (95% CI 51–66%) and OS was 50% (95% CI 43–57%). Dose reduction was not necessary; toxicity was minimal and well controlled. No death related to acute or late toxicities has been observed.
Conclusion
Low doses of cytotoxic agents for continuous, prolonged periods, with minimal drug-free intervals, represent a novel, active, and easily tolerated approach to management of patients with DLBCL in a terminal phase and improved outcome.
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The present work did not receive any financial support and was performed with the owner resources of the Insituto Mexicano del Seguro Social.
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Conception and design: AA, NN. Administrative support: not necessary. Provision of study materials or patients: AA, NN, SC, LS. Collection and assembly of dates: AA, NN, SC, LS. Data analysis and interpretation. AA, NN., SC, LS. Manuscript writing: AA, NN, SC, LS. Final approval of manuscript: AA, NN, SC, LS.
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Avilés, A., Nambo, MJ., Neri, N. et al. A new therapeutic approach in very refractory diffuse large B-cell lymphoma. Clin Transl Oncol 22, 703–707 (2020). https://doi.org/10.1007/s12094-019-02172-1
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DOI: https://doi.org/10.1007/s12094-019-02172-1