Gemcitabine, dexamethasone, and cisplatin salvage in relapsed lymphomas: A single institutional experience

• Main Authors: Avaronnan Manuprasad, Praveen Kumar Shenoy, Vineetha Raghavan, K M Shiljina, Chandran K Nair
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Cancer Research, Statistics, and Treatment
• Subjects: diffuse large b-cell lymphoma; gemcitabine; dexamethasone; cisplatin; india; relapsed lymphoma; salvage chemotherapy; gdp; lmic; dlbcl; lymphoma
• Online Access: http://www.crstonline.com/article.asp?issn=2590-3233;year=2020;volume=3;issue=1;spage=13;epage=18;aulast=Manuprasad

Introduction: Salvage chemotherapy followed by autologous stem cell transplantation is the standard of care in relapsed lymphoma. The optimal regimen for salvage is not defined. The combination of gemcitabine, dexamethasone, and cisplatin (GDP) is an outpatient regimen which can lead to high response rates with minimal toxicity. Methods: This was a retrospective study of all patients with relapsed diffuse large B-cell lymphoma, Hodgkin's lymphoma (HL), or peripheral T-cell lymphoma who received GDP as salvage chemotherapy between January 2014 and December 2017. Baseline characteristics, treatment details, toxicity, and outcomes including survival were analyzed. Results: We included 39 patients in the study. The most common indication was relapsed high grade B-cell non-Hodgkin's lymphoma (NHL) (n = 20, 51%) followed by HL (n = 10, 25%) and T-cell NHL (n = 9, 24%). The median age was 46 years (range, 17–62 years); 27 patients (69%) were males. The most common Grade 3/4 toxicity was thrombocytopenia (n = 7, 18%) followed by neutropenia (n = 5, 12%) and anemia (n = 3, 8%). Overall response rate for GDP was 64% (complete response-10%, partial response-54%). Of the 30 patients who were eligible for transplant, 16 (57%) could undergo transplant. At a median follow-up of 12 months, the 2-year overall survival (OS) and progression-free survival (PFS) were 50% and 38% for the entire patient cohort. The 2-year OS was 68% in the patients who underwent transplant and 38% in the non-transplant group. The 2-year PFS was 58% in those who underwent transplant and 18% in those who did not undergo transplant. Conclusions: GDP is an effective and well-tolerated salvage regimen in relapsed lymphoma. The regimen is feasible in a resource-limited setting.