PALLIATIVE CHEMOTHERAPY PEPC (PREDNISOLONE, ETOPOSIDE, PROCARBAZINE AND CYCLOPHOSPHAMIDE) IS EFFECTIVE AND TOLERABLE IN PATIENTS WITH RELAPSED/REFRACTORY LYMPHOMAS
(Abstract release date: 05/19/16)
EHA Library. Kriachok I. 06/09/16; 133000; E1451
Prof. Dr. Iryna Kriachok
Contributions
Contributions
Abstract
Abstract: E1451
Type: Eposter Presentation
Background
Nowadays there are no universally accepted protocols and specific criteria for carrying out palliative chemotherapy in patients with lymphoproliferative diseases. The main problem of palliative chemotherapy is to choose an optimal treatment strategy for conducting effective therapy with minimization of adverse events. Therefore, there are a lot of needs to organize studies to improve palliative chemotherapy protocols in patients with lymphomas.
Aims
In the department of oncohematology the present trial was aimed to study the efficacy and toxicity of PEPC chemotherapy in research period from August 2011 to November 2015.
Methods
A total of 70 patients were included in study who received PEPC chemotherapy with palliation aim. Indications for palliative treatment were: relapsed or refractory Hodgkin or Non-Hodgkin lymphomas after 2nd and 3rd line treatment without efficacy and contraindications of further treatment, with the aim of nonradical treatment. Patients received therapy every day till leukocytes level <3 x 10 9/L : prednisone 20 mg, cyclophosphamide 50 mg, etoposide 50 mg, procarbazine 50 mg. When leukocytes level decreased below (<3 x 10 9/L) therapy was stopped and then renewed when leukocytes were recovered > 3 x 10 9/L in every day regimen or every other day or fractional regimen (5 times a week, then 2 day break). The daily dose was always the same, perhaps it was only a change in the number of days in a week in which to take the drugs. Another goal was to investigate subjective improvement in general condition
Results
A total of 70 patients were enrolled. Median age of patients was 46,85 ± 4,3 years ( from 19 to 74 years old), 38 man, 32 woman. There were included 25 patients with Hodgkin’s lymphoma and 45 – Non-Hodgkin lymphoma (large B-cell lymphoma – 35 pts, MZL – 35, CLL/SLL – 2, T-lymphoblastic – 3, peripheral T-cell lymphoma – 1, anaplastic – 1). Relapsed lymphoma was diagnosed in 37 patients. The number of relapses ranged from 1 to 5 (median 1,69 ± 0.90). Refractory lymphoma was observed in 43 patients. As a second and third line treatment patients received DHAP, GVP, GEMOX, ICE, MINE chemotherapy. Prior to palliative course they received an average of 2.03 + 0.62 - treatment lines (from 1 to 5 salvage-regimens). Response rate to therapy was assessed in 46 patients. OR was achieved in 36,95 % (n = 17), CR - 6,52 % (n = 3), PR - 30,43 % (n = 14), SD - 39,13 % (n = 18). All patients had subjective improvement in general condition. PD on therapy with no apparent positive response was observed in 23.91 % patients (n = 11). Duration on PEPC therapy ranged from 1 to 15 months, average duration of therapy was 5,15 ± 2,01 months (from 3 to 20 months). Nonhematologic toxicities (II / III grade CTC NCI v.4.02) are seen in 19 patients (27,14 %). Infectious complications were observed in 3 patients (8,1 %), febrile neutropenia (grade III-IV) - 27 (29,7 %) and grade I-II - 12 (17,14 %). Grade III anemia occurred in 5 patients (7,14 %), grade II anemia – in 23 (32,85 %). Thrombocytopenia (grade III) registered in 3 patients (4,28 %) without hemorrhagic syndrome.Currently, 22 (31.4 %) patients continue treatment. Because of disease progression 48 patients died.
Conclusion
PEPC chemotherapy is an effective treatment for extremely unfavorable group of patients with relapsed/refractory non-Hodgkin’s lymphoma and Hodgkin’s lymphoma and has an acceptable toxicity profile.
Session topic: E-poster
Keyword(s): Chemotherapy, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, Relapse
Type: Eposter Presentation
Background
Nowadays there are no universally accepted protocols and specific criteria for carrying out palliative chemotherapy in patients with lymphoproliferative diseases. The main problem of palliative chemotherapy is to choose an optimal treatment strategy for conducting effective therapy with minimization of adverse events. Therefore, there are a lot of needs to organize studies to improve palliative chemotherapy protocols in patients with lymphomas.
Aims
In the department of oncohematology the present trial was aimed to study the efficacy and toxicity of PEPC chemotherapy in research period from August 2011 to November 2015.
Methods
A total of 70 patients were included in study who received PEPC chemotherapy with palliation aim. Indications for palliative treatment were: relapsed or refractory Hodgkin or Non-Hodgkin lymphomas after 2nd and 3rd line treatment without efficacy and contraindications of further treatment, with the aim of nonradical treatment. Patients received therapy every day till leukocytes level <3 x 10 9/L : prednisone 20 mg, cyclophosphamide 50 mg, etoposide 50 mg, procarbazine 50 mg. When leukocytes level decreased below (<3 x 10 9/L) therapy was stopped and then renewed when leukocytes were recovered > 3 x 10 9/L in every day regimen or every other day or fractional regimen (5 times a week, then 2 day break). The daily dose was always the same, perhaps it was only a change in the number of days in a week in which to take the drugs. Another goal was to investigate subjective improvement in general condition
Results
A total of 70 patients were enrolled. Median age of patients was 46,85 ± 4,3 years ( from 19 to 74 years old), 38 man, 32 woman. There were included 25 patients with Hodgkin’s lymphoma and 45 – Non-Hodgkin lymphoma (large B-cell lymphoma – 35 pts, MZL – 35, CLL/SLL – 2, T-lymphoblastic – 3, peripheral T-cell lymphoma – 1, anaplastic – 1). Relapsed lymphoma was diagnosed in 37 patients. The number of relapses ranged from 1 to 5 (median 1,69 ± 0.90). Refractory lymphoma was observed in 43 patients. As a second and third line treatment patients received DHAP, GVP, GEMOX, ICE, MINE chemotherapy. Prior to palliative course they received an average of 2.03 + 0.62 - treatment lines (from 1 to 5 salvage-regimens). Response rate to therapy was assessed in 46 patients. OR was achieved in 36,95 % (n = 17), CR - 6,52 % (n = 3), PR - 30,43 % (n = 14), SD - 39,13 % (n = 18). All patients had subjective improvement in general condition. PD on therapy with no apparent positive response was observed in 23.91 % patients (n = 11). Duration on PEPC therapy ranged from 1 to 15 months, average duration of therapy was 5,15 ± 2,01 months (from 3 to 20 months). Nonhematologic toxicities (II / III grade CTC NCI v.4.02) are seen in 19 patients (27,14 %). Infectious complications were observed in 3 patients (8,1 %), febrile neutropenia (grade III-IV) - 27 (29,7 %) and grade I-II - 12 (17,14 %). Grade III anemia occurred in 5 patients (7,14 %), grade II anemia – in 23 (32,85 %). Thrombocytopenia (grade III) registered in 3 patients (4,28 %) without hemorrhagic syndrome.Currently, 22 (31.4 %) patients continue treatment. Because of disease progression 48 patients died.
Conclusion
PEPC chemotherapy is an effective treatment for extremely unfavorable group of patients with relapsed/refractory non-Hodgkin’s lymphoma and Hodgkin’s lymphoma and has an acceptable toxicity profile.
Session topic: E-poster
Keyword(s): Chemotherapy, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, Relapse
Abstract: E1451
Type: Eposter Presentation
Background
Nowadays there are no universally accepted protocols and specific criteria for carrying out palliative chemotherapy in patients with lymphoproliferative diseases. The main problem of palliative chemotherapy is to choose an optimal treatment strategy for conducting effective therapy with minimization of adverse events. Therefore, there are a lot of needs to organize studies to improve palliative chemotherapy protocols in patients with lymphomas.
Aims
In the department of oncohematology the present trial was aimed to study the efficacy and toxicity of PEPC chemotherapy in research period from August 2011 to November 2015.
Methods
A total of 70 patients were included in study who received PEPC chemotherapy with palliation aim. Indications for palliative treatment were: relapsed or refractory Hodgkin or Non-Hodgkin lymphomas after 2nd and 3rd line treatment without efficacy and contraindications of further treatment, with the aim of nonradical treatment. Patients received therapy every day till leukocytes level <3 x 10 9/L : prednisone 20 mg, cyclophosphamide 50 mg, etoposide 50 mg, procarbazine 50 mg. When leukocytes level decreased below (<3 x 10 9/L) therapy was stopped and then renewed when leukocytes were recovered > 3 x 10 9/L in every day regimen or every other day or fractional regimen (5 times a week, then 2 day break). The daily dose was always the same, perhaps it was only a change in the number of days in a week in which to take the drugs. Another goal was to investigate subjective improvement in general condition
Results
A total of 70 patients were enrolled. Median age of patients was 46,85 ± 4,3 years ( from 19 to 74 years old), 38 man, 32 woman. There were included 25 patients with Hodgkin’s lymphoma and 45 – Non-Hodgkin lymphoma (large B-cell lymphoma – 35 pts, MZL – 35, CLL/SLL – 2, T-lymphoblastic – 3, peripheral T-cell lymphoma – 1, anaplastic – 1). Relapsed lymphoma was diagnosed in 37 patients. The number of relapses ranged from 1 to 5 (median 1,69 ± 0.90). Refractory lymphoma was observed in 43 patients. As a second and third line treatment patients received DHAP, GVP, GEMOX, ICE, MINE chemotherapy. Prior to palliative course they received an average of 2.03 + 0.62 - treatment lines (from 1 to 5 salvage-regimens). Response rate to therapy was assessed in 46 patients. OR was achieved in 36,95 % (n = 17), CR - 6,52 % (n = 3), PR - 30,43 % (n = 14), SD - 39,13 % (n = 18). All patients had subjective improvement in general condition. PD on therapy with no apparent positive response was observed in 23.91 % patients (n = 11). Duration on PEPC therapy ranged from 1 to 15 months, average duration of therapy was 5,15 ± 2,01 months (from 3 to 20 months). Nonhematologic toxicities (II / III grade CTC NCI v.4.02) are seen in 19 patients (27,14 %). Infectious complications were observed in 3 patients (8,1 %), febrile neutropenia (grade III-IV) - 27 (29,7 %) and grade I-II - 12 (17,14 %). Grade III anemia occurred in 5 patients (7,14 %), grade II anemia – in 23 (32,85 %). Thrombocytopenia (grade III) registered in 3 patients (4,28 %) without hemorrhagic syndrome.Currently, 22 (31.4 %) patients continue treatment. Because of disease progression 48 patients died.
Conclusion
PEPC chemotherapy is an effective treatment for extremely unfavorable group of patients with relapsed/refractory non-Hodgkin’s lymphoma and Hodgkin’s lymphoma and has an acceptable toxicity profile.
Session topic: E-poster
Keyword(s): Chemotherapy, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, Relapse
Type: Eposter Presentation
Background
Nowadays there are no universally accepted protocols and specific criteria for carrying out palliative chemotherapy in patients with lymphoproliferative diseases. The main problem of palliative chemotherapy is to choose an optimal treatment strategy for conducting effective therapy with minimization of adverse events. Therefore, there are a lot of needs to organize studies to improve palliative chemotherapy protocols in patients with lymphomas.
Aims
In the department of oncohematology the present trial was aimed to study the efficacy and toxicity of PEPC chemotherapy in research period from August 2011 to November 2015.
Methods
A total of 70 patients were included in study who received PEPC chemotherapy with palliation aim. Indications for palliative treatment were: relapsed or refractory Hodgkin or Non-Hodgkin lymphomas after 2nd and 3rd line treatment without efficacy and contraindications of further treatment, with the aim of nonradical treatment. Patients received therapy every day till leukocytes level <3 x 10 9/L : prednisone 20 mg, cyclophosphamide 50 mg, etoposide 50 mg, procarbazine 50 mg. When leukocytes level decreased below (<3 x 10 9/L) therapy was stopped and then renewed when leukocytes were recovered > 3 x 10 9/L in every day regimen or every other day or fractional regimen (5 times a week, then 2 day break). The daily dose was always the same, perhaps it was only a change in the number of days in a week in which to take the drugs. Another goal was to investigate subjective improvement in general condition
Results
A total of 70 patients were enrolled. Median age of patients was 46,85 ± 4,3 years ( from 19 to 74 years old), 38 man, 32 woman. There were included 25 patients with Hodgkin’s lymphoma and 45 – Non-Hodgkin lymphoma (large B-cell lymphoma – 35 pts, MZL – 35, CLL/SLL – 2, T-lymphoblastic – 3, peripheral T-cell lymphoma – 1, anaplastic – 1). Relapsed lymphoma was diagnosed in 37 patients. The number of relapses ranged from 1 to 5 (median 1,69 ± 0.90). Refractory lymphoma was observed in 43 patients. As a second and third line treatment patients received DHAP, GVP, GEMOX, ICE, MINE chemotherapy. Prior to palliative course they received an average of 2.03 + 0.62 - treatment lines (from 1 to 5 salvage-regimens). Response rate to therapy was assessed in 46 patients. OR was achieved in 36,95 % (n = 17), CR - 6,52 % (n = 3), PR - 30,43 % (n = 14), SD - 39,13 % (n = 18). All patients had subjective improvement in general condition. PD on therapy with no apparent positive response was observed in 23.91 % patients (n = 11). Duration on PEPC therapy ranged from 1 to 15 months, average duration of therapy was 5,15 ± 2,01 months (from 3 to 20 months). Nonhematologic toxicities (II / III grade CTC NCI v.4.02) are seen in 19 patients (27,14 %). Infectious complications were observed in 3 patients (8,1 %), febrile neutropenia (grade III-IV) - 27 (29,7 %) and grade I-II - 12 (17,14 %). Grade III anemia occurred in 5 patients (7,14 %), grade II anemia – in 23 (32,85 %). Thrombocytopenia (grade III) registered in 3 patients (4,28 %) without hemorrhagic syndrome.Currently, 22 (31.4 %) patients continue treatment. Because of disease progression 48 patients died.
Conclusion
PEPC chemotherapy is an effective treatment for extremely unfavorable group of patients with relapsed/refractory non-Hodgkin’s lymphoma and Hodgkin’s lymphoma and has an acceptable toxicity profile.
Session topic: E-poster
Keyword(s): Chemotherapy, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, Relapse
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