Skip to main content
SpringerLink
Log in

Promising long-term outcome of gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule as salvage regimen for patients with previously heavily treated Hodgkin’s lymphoma and aggressive non-Hodgkin’s lymphoma

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

The combination of gemcitabine (G), vinorelbine (V), and pegylated liposomal doxorubicin (D) has proved to be effective in relapsed Hodgkin’s lymphoma (HL). Its efficacy in non-Hodgkin’s lymphoma (NHL) remains to be discussed. We retrospectively evaluated the efficacy and toxicity of the dose-adjusted gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule in 35 heavily pretreated patients with relapsed and refractory aggressive NHL or HL. Treatment consisted of G: 800 mg/m2 intravenous (i.v.) on day 1, V: 15 mg/m2 i.v. on day 1; D: 20 mg/m2 i.v. on day 1, repeated for 14 days. Patients responded to GVD proceeded to subsequent autologous stem cell transplantation. The objective response rate (ORR) was 48.6 %, with 31.4 % complete remission. A higher ORR was observed in patients with HL than in patients with NHL (80.0 vs. 36.0 %, P = 0.023). With a median follow-up of 26 months, the estimated median progression-free survival and overall survival were 5 (range 1–73 months) and 36 months (range 2–73 months), respectively. The estimated 5-year survival rate was 44.6 % (95 % confidence interval 28.1–61.1 %). Toxicities were mild (grade 3/4 neutropenia 34.3 %, thrombocytopenia 5.7 %). Our results suggest that the dose-adjusted GVD in 14-day schedule is effective and well tolerated in patients with refractory and relapsed HL and aggressive NHL. The potential long-term survival in NHL is promising.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Brice P. Managing relapsed and refractory Hodgkin lymphoma. Br J Haematol. 2008;141(1):3–13.

    Article  PubMed  Google Scholar 

  2. Appelbaum FR. Hematopoietic cell transplantation for non-Hodgkin’s lymphoma: yesterday, today, and tomorrow. J Clin Oncol. 2008;26(18):2927–9.

    Article  PubMed  Google Scholar 

  3. Bartlett NL, Niedzwiecki D, Johnson JL, et al. Gemcitabine, vinorelbine, and pegylated liposomal doxorubicin (GVD), a salvage regimen in relapsed Hodgkin’s lymphoma: CALGB 59804. Ann Oncol. 2007;18(6):1071–9.

    Article  PubMed  CAS  Google Scholar 

  4. Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579–86.

    Article  PubMed  Google Scholar 

  5. Lazarus HM, Loberiza FR Jr, Zhang MJ, et al. Autotransplants for Hodgkin’s disease in first relapse or second remission: a report from the autologous blood and marrow transplant registry (ABMTR). Bone Marrow Transplant. 2001;27(4):387–96.

    Article  PubMed  CAS  Google Scholar 

  6. Sureda A, Constans M, Iriondo A, et al. Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin’s lymphoma autografted after a first relapse. Ann Oncol. 2005;16(4):625–33.

    Article  PubMed  CAS  Google Scholar 

  7. Brandwein JM, Callum J, Sutcliffe SB, et al. Evaluation of cytoreductive therapy prior to high dose treatment with autologous bone marrow transplantation in relapsed and refractory Hodgkin’s disease. Bone Marrow Transplant. 1990;5(2):99–103.

    PubMed  CAS  Google Scholar 

  8. Schmitz N, Pfistner B, Sextro M, et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002;359(9323):2065–71.

    Article  PubMed  CAS  Google Scholar 

  9. Velasquez WS, Cabanillas F, Salvador P, et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood. 1988;71(1):117–22.

    PubMed  CAS  Google Scholar 

  10. Moskowitz CH, Bertino JR, Glassman JR, et al. Ifosfamide, carboplatin, and etoposide: a highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant-eligible patients with non-Hodgkin’s lymphoma. J Clin Oncol. 1999;17(12):3776–85.

    PubMed  CAS  Google Scholar 

  11. Velasquez WS, McLaughlin P, Tucker S, et al. ESHAP—an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994;12(6):1169–76.

    PubMed  CAS  Google Scholar 

  12. Rodriguez MA, Cabanillas FC, Hagemeister FB, et al. A phase II trial of mesna/ifosfamide, mitoxantrone and etoposide for refractory lymphomas. Ann Oncol. 1995;6(6):609–11.

    PubMed  CAS  Google Scholar 

  13. Baetz T, Belch A, Couban S, et al. Gemcitabine, dexamethasone and cisplatin is an active and non-toxic chemotherapy regimen in relapsed or refractory Hodgkin’s disease: a phase II study by the National Cancer Institute of Canada Clinical Trials Group. Ann Oncol. 2003;14(12):1762–7.

    Article  PubMed  CAS  Google Scholar 

  14. Fracasso PM, Blum KA, Tan BR, et al. Phase I study of pegylated liposomal doxorubicin and gemcitabine in patients with advanced malignancies. Cancer. 2002;95(10):2223–9.

    Article  PubMed  CAS  Google Scholar 

  15. Gridelli C, Frontini L, Perrone F, et al. Gemcitabine plus vinorelbine in advanced non-small cell lung cancer: a phase II study of three different doses. Gem Vin Investig Br J Cancer. 2000;83(6):707–14.

    Article  CAS  Google Scholar 

  16. Gabizon AA. Pegylated liposomal doxorubicin: metamorphosis of an old drug into a new form of chemotherapy. Cancer Invest. 2001;19(4):424–36.

    Article  PubMed  CAS  Google Scholar 

  17. Orditura M, Quaglia F, Morgillo F, et al. Pegylated liposomal doxorubicin: pharmacologic and clinical evidence of potent antitumor activity with reduced anthracycline-induced cardiotoxicity (review). Oncol Rep. 2004;12(3):549–56.

    PubMed  CAS  Google Scholar 

  18. Martin A, Fernandez-Jimenez MC, Caballero MD, et al. Long-term follow-up in patients treated with mini-BEAM as salvage therapy for relapsed or refractory Hodgkin’s disease. Br J Haematol. 2001;113(1):161–71.

    Article  PubMed  CAS  Google Scholar 

  19. Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med. 1995;333(23):1540–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Yu-Shan Liu for her excellent support on data collection.

Conflict of interest

All authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People’s Republic of China

    Bing Bai, Hui-Qiang Huang, Qing-Qing Cai, Xiao-Xiao Wang, Qi-Chun Cai, Yan Gao, Yi Xia & Ying Guo

  2. State Key Laboratory of Oncology in South China, 651 Dongfeng East Road, Guangzhou, Guangdong, People’s Republic of China

    Bing Bai, Hui-Qiang Huang, Qing-Qing Cai, Xiao-Xiao Wang, Qi-Chun Cai, Yan Gao, Yi Xia & Ying Guo

  3. Sun Yat-sen Institute of Hematology, 651 Dongfeng East Road, Guangzhou, Guangdong, People’s Republic of China

    Bing Bai, Hui-Qiang Huang, Qing-Qing Cai, Xiao-Xiao Wang, Qi-Chun Cai, Yan Gao & Yi Xia

  4. Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tian He Road, Guangzhou, Guangdong, People’s Republic of China

    Ze-Xiao Lin

  5. Affiliated Hospital of Guilin Medical College, 15 Le Qun Road, Guilin, People’s Republic of China

    Qing Bu

  6. Clinical Trial Center, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, People’s Republic of China

    Ying Guo

Authors
  1. Bing Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui-Qiang Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qing-Qing Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiao-Xiao Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qi-Chun Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ze-Xiao Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yan Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yi Xia
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Qing Bu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ying Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hui-Qiang Huang.

Additional information

Bing Bai and Hui-Qiang Huang The first two authors contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bai, B., Huang, HQ., Cai, QQ. et al. Promising long-term outcome of gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule as salvage regimen for patients with previously heavily treated Hodgkin’s lymphoma and aggressive non-Hodgkin’s lymphoma. Med Oncol 30, 350 (2013). https://doi.org/10.1007/s12032-012-0350-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-012-0350-5

Keywords

Search

Navigation