The efficacy and safety of gemcitabine, dexamethasone, and cisplatine (GDP) therapy for relapsed/refractory lymphoma

Abstract

Background: Gemcitabine, dexamethasone, and cisplatine (GDP) therapy is a novel salvage regimen for relapsed/refractory lymphoma. The efficacy of GDP for transplant eligible patients ( pts) was confirmed by a prospective randomized study. But, there have not been reported enough about GDP in Japan. Methods: We retrospectively analyzed the clinical outcomes of pts treated with GDP during 2013 - 2015. Chart reviews were performed to obtain the following information; patient characteristics, overall response rate (ORR), overall survival (OS), progression free survival (PFS), and adverse effects. Results: Fourteen pts were available for this analysis. Eleven cases were diffuse large Bcell lymphoma, one case was peripheral T cell lymphoma, not other specified, and one case was mantle cell lymphoma. Pts with B cell phenotype were treated in combination with rituximab. Median age was 64.5 (range 46-85). Seven pts were transplant ineligible due to high age. The median number of regimens prior to GDP was 2 (range 1-6). The median cycles of GDP were 4 (range 1-6). Fifty two cycles of GDP were done. Twelve of these 52 cycles were administrated at outpatient setting. ORR was 61.5% (8 pts), with 30% CR (4 pts) and 30% PR (4 pts). Six pts (42%) were SD, and no refractory case was seen. The median follow up time was 6.6 months (range 3-11 months). Grade 3/4 neutropenia and thrombocytopenia were common (92% and 92%, respectively). Majority of pts needed blood transfusion (RCC in 50% of cycles and PC in 75% of cycles) and granulocyte-colony stimulating factor (G-CSF) (97% of cycles). Febrile neutropenia was documented in 13% of cycles. Grade ≥ 3 non-hematological toxicities were not documented. Conclusions: GDP therapy would be effective for not only transplant eligible pts but also ineligible elderly pts. Some cases could be treated in outpatient setting. Severe hematological toxicity was common and adequate support including blood transfusion and G-CSF were needed.