Dexamethasone, High-Dose Cytarabine, And Oxaliplatin (Dhaox), And Rituximab Plus Dhaox (R-Ohaox) For Treatment Of Patients With B-Cell Non-Hodgkin'S Lymphoma: Results From Two Consecutive Phase Ii Studies

JOURNAL OF CLINICAL ONCOLOGY(2004)

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6681 Background: To determine, from two consecutive phase II studies, the efficacy of oxaliplatin (L-OHP), cytarabine (ara-C), and dexamethasone (DHAOx), and DHAOx plus rituximab (R-DHAOx), in patients with non-Hodgkin's lymphoma (NHL). Methods: In Study I, treatment consisted of DHAOx (dexamethasone, 40 mg/day, days 1 to 4; L-OHP, 130 mg/m2, day 1; and ara-C, 2,000 mg/m2, every 12 hrs, day 2). In Study II, treatment consisted of R-DHAOx (DHAOx plus rituximab, on day 1, 375 mg/m2). Courses were repeated every 21 days. Patients had failed to achieve a complete response (CR) with initial chemotherapy, were in relapse, or could not receive standard treatment. Results: Response to therapy: Study I: Eight patients (61.5%) achieved a CR, and 1 (8%) had a PR. None of the complete responders has relapsed; they had a median disease-free survival (DFS) of 44.6 months. Study II: Fifteen patients (68%) achieved a CR, and 3 (13.5%) had a PR. None of the complete responders has relapsed; they had a median DFS of 19.8 months. Responses were obtained in lymphomas of follicular, marginal-zone, mantle-cell, and diffuse large B-cell subtypes, and in patients with or without resistance to prior chemotherapy. Disappearance of molecular markers occurred in all of the complete responders whose tumor cells carried markers. Toxicity: Myelosuppression and dose-related peripheral neuropathy were the most prominent toxic effects. Conclusions: DHAOx and R-DHAOx are highly active for salvage treatment of patients with B-cell NHLs, and possess toxicity characteristics which compare favorably to those reported with ara-C plus cisplatin-containing regimens. No significant financial relationships to disclose.
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lymphoma,oxaliplatin,rituximab,high-dose,r-dhaox,b-cell,non-hodgkin
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