Gemcitabine and treatment of diffuse large B-cell lymphoma in relapsed or refractory elderly patients: A prospective randomized trial in Algeria
| Autor: | Abdesselam Taleb, Kamel Bouzid, Badr-Eddine Sari, Hadj Touhami, Kaoual Meguenni, Naima Mesli, Nesrine Remla, Mohamed Amine Bekadja, Zahia Zouaoui-Benhadji, Mourad Aribi |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty gemcitabine-based therapy medicine.medical_treatment Context (language use) Kaplan-Meier Estimate elderly patients lcsh:RC254-282 Deoxycytidine Methylprednisolone Gastroenterology Dexamethasone Disease-Free Survival Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Etoposide Aged relapse ESHAP Regimen Chemotherapy business.industry Cytarabine Diffuse large B-cell lymphoma General Medicine Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Gemcitabine Surgery refractory Regimen Oncology Female Lymphoma Large B-Cell Diffuse Cisplatin Neoplasm Recurrence Local ESHAP business medicine.drug |
| Zdroj: | Journal of Cancer Research and Therapeutics, Vol 6, Iss 1, Pp 41-46 (2010) |
| ISSN: | 0973-1482 |
| Popis: | Context: Support for non-Hodgkin′s lymphoma (NHL) with large cells that is refractory or relapsed after first-line chemotherapy poses a greater therapeutic problem with bone marrow transplant therapy or when old age is a contra-indication for high-dose chemotherapy, especially among developing countries such as Algeria. Aim: To show that the regimen, including gemcitabine, could be more effective in treating elderly patients with diffuse large B-cell lymphoma (DLBCL) in relapse / refractory, without complete remission, when compared with the ESHAP (etoposide, cisplatine, solumedrol, aracytine) regimen. Materials and Methods: Ninety-six patients in the age group of 60-70 years were volunteers for a prospective randomized single-blind study, carried out for three years. Patients were divided into two groups by the drawing of lots. The first group (GA, n = 48, relapse; n = 27 [56.3%], refractory; n = 21 [43.7%]) received treatment with ESHAP protocol and the second one (GB, n = 48, relapse; n = 28 [58%], refractory; n = 20 [42%]) with GPD (gemcitabine, dexamethasone, cisplatine) protocol. Results: The overall response rates and mean survival at three years were significantly higher among patients subjected to GPD treatment compared with those subjected to ESHAP treatment (63% vs. 55%, P = 0.01 and 20.5% [95% CI 16.5-24.5] vs. 11.8% [8.9-14.6], respectively). Additionally, three-year progression-free and event-free survival rates were 20.5% (16.3-24) and 19.7% (15.9-23.5), respectively, for the GPD regimen and 10.9% (8.2-13.7) and 11.1% (95% CI 8.5-13.7), respectively, for the ESHAP regimen. Moreover, the GPD regimen was associated with improving overall survival (RR=2.02, 95% CI 1.59-2.56; P = 0.000), event-free survival (2.03, 1.64-2.52; P < 0.001) and progression-free survival (1.86, 1.46-2.37; P < 0.001). Conclusion: In cases of contra-indication for high-dose chemotherapy for elderly patients with DLBCL, without complete remission, the Gemcitabine-based therapy protocol represents a more effective and less toxic than that of ESHAP. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|