A multicenter phase II trial of etoposide, methylprednisolone, high-dose cytarabine, and oxaliplatin for patients with primary refractory/relapsed aggressive non-Hodgkin’s lymphoma
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We investigated the efficacy and toxicity of the etoposide, methylprednisolone, high-dose cytarabine, and oxaliplatin (ESHAOx), in which oxaliplatin (Ox) was substituted for cisplatin in the ESHAP [etoposide (E), methylprednisolone (S), high-dose cytarabine (HA), and cisplatin (P)] regimen, for patients with refractory/relapsed aggressive non-Hodgkin’s lymphoma (NHL).
Materials and methods
The ESHAOx consisted of E (40 mg/m2 on days 1–4), S (500 mg on days 1–5), HA (2 g/m2 on day 5), and Ox (130 mg/m2 on day 1) every 3 weeks to a maximum of six cycles. Responses were assessed every three cycles.
Twenty-seven patients were enrolled (19 with relapsed and 8 with refractory; 10 with an IPI score of 3–5). The overall response rate was 63% [95% confidence interval (95% CI) 45–81%], including eight complete remissions (CR) and one unconfirmed CR (33%). The median duration of response was 9.9 months (95% CI 5.7–14.2 months). After a median follow-up of 18.6 months, the median progression-free and overall survival was 5.3 months (95% CI 3.9–6.7 months) and 15.1 months (95% CI 9.4–20.9 months), respectively, with a 1-year survival rate of 61.5%. Most common grade 3/4 hematologic toxicities were neutropenia (56%) and thrombocytopenia (35%), whereas no patient experienced grade 3/4 renal or neurotoxicity.
The efficacy and toxicity profiles suggested that the ESHAOx can be an alternative option for patients with refractory/relapsed aggressive NHL.