Retrospective Analysis of the Efficacy and Tolerability of Gemcitabine-Based Chemotherapy in Relapsed/Refractory Lymphoma Patients Not Eligible for Stem Cell Transplant

Clin Lymphoma Myeloma Leuk. 2022 Nov;22(11):835-840. doi: 10.1016/j.clml.2022.06.010. Epub 2022 Jun 29.

Abstract

Introduction: Gemcitabine-based regimens are effective salvage therapy for RR lymphoma patients eligible for ASCT, but there is limited data in transplant-ineligible (TIE) patients. Here, we present a retrospective analysis on the outcome of TIE adult patients with RR lymphoma treated with gemcitabine, cisplatin or carboplatin and dexamethasone (GDP/GDCarboP) +/- rituximab regimen in our center.

Patients: We identified 33 patients: 54.5% diffuse large Bcell lymphoma (DLBCL), 6.1% double/triple hit lymphoma, 15% follicular lymphoma, 18% T-cell lymphoma, and 6% classical Hodgkin lymphoma. Majority of the patients had advanced-stage disease and raised LDH at relapse. The cohort's median age was 71 years. The median number of prior lines of treatment was 2, and 60.6% were refractory to their last line of treatment.

Results: The overall response rate was 33% (complete response 15%) for the entire cohort and 62.5% for DLBCL patients not refractory to prior line of treatment. At median follow-up of 25 months, the median duration of response and overall survival in the responders were not reached. Conversely, the median overall survival for the non-responders was dismal at 5 months. Fifty-five percent required treatment alteration (dose attenuation or omission and treatment delay for >1 week) due to adverse events, 73% needed transfusion, and 70% had at least 1 hospital admission during treatment.

Conclusion: Our real-world data showed that GDP/GDCarboP provides meaningful efficacy and durability, especially among the responders. However, dose modification and inpatient support are frequently needed, indicating the need for good supportive care and close follow-up in this frailer population.

Keywords: GDP GDCarboP; Gemcitabine; Relapsed/refractory diffuse large B-cell lymphoma; Transplant-ineligible.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Carboplatin / therapeutic use
  • Cisplatin / therapeutic use
  • Dexamethasone / adverse effects
  • Gemcitabine
  • Humans
  • Lymphoma, B-Cell* / drug therapy
  • Lymphoma, Follicular* / drug therapy
  • Lymphoma, Non-Hodgkin* / drug therapy
  • Neoplasm Recurrence, Local / drug therapy
  • Retrospective Studies
  • Rituximab / therapeutic use
  • Stem Cell Transplantation

Substances

  • Cisplatin
  • Carboplatin
  • Rituximab
  • Dexamethasone
  • Gemcitabine