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

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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.

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Acknowledgments

We gratefully acknowledge CJ Corporation, Seoul, Korea, for supplying irinotecan (Campto®) for our study.

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Authors and Affiliations

  1. Division of Hematology–Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, South Korea

    Hye Jin Kang & Baek-Yeol Ryoo

  2. Division of Hematology–Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Won Seog Kim & Yeon Hee Park

  3. Division of Oncology, Department of Internal Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea

    Cheolwon Suh

  4. Division of Hematology–Oncology, Department of Internal Medicine, Seoul Veterans Hospital, Seoul, South Korea

    Bong Seog Kim

  5. Division of Hematology–Oncology, Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea

    Young Jin Yuh

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  1. Hye Jin Kang
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  2. Won Seog Kim
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  3. Cheolwon Suh
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  7. Baek-Yeol Ryoo
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Corresponding author

Correspondence to Baek-Yeol Ryoo.

Additional information

H.J. Kang and W.S. Kim contributed equally to the work.

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Kang, H.J., Kim, W.S., Suh, C. et al. Irinotecan plus cisplatin and dexamethasone (ICD) combination chemotherapy for patients with diffuse large B-cell lymphoma previously treated with Rituximab plus CHOP. Cancer Chemother Pharmacol 62, 299–304 (2008). https://doi.org/10.1007/s00280-007-0607-4

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  • DOI: https://doi.org/10.1007/s00280-007-0607-4

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