Study on effectiveness of gemcitabine, dexamethasone, and cisplatin (GDP) for relapsed or refractory AIDS-related non-Hodgkins lymphoma
Annals of Hematology, 07/18/2012
Zhong DT et al. – This study confirms that gemcitabine, dexamethasone, and cisplatin (GDP) is an effective and safe salvage regimen in relapsed or refractory AIDS–Non–Hodgkin's lymphoma (NHL), was associated with modest declines in CD4+ lymphocyte counts, and did not promote human immunodeficiency virus (HIV)–1 viral replication.Methods
- Forty-eight patients with relapsed or refractory AIDS-NHL were treated with intravenous combination chemotherapy with GDP.
- The overall objective response rate was 54.1 % (95 % confidence interval, CI, 40.1–68.3 %), with 10 complete responses and 16 partial responses.
- The 2-year overall survival rate (OS) was 70.8 % (95 % CI 58.0–83.7 %), and the 5-year OS was 41.7 % (95 % CI 27.7–55.6 %).
- The 2-year progression-free survival rate (PFS) was 37.5 % (95 % CI 23.8–51.2 %), and the 5-year PFS was 25.0 % (95 % CI 12.8–37.3 %).
- The median progression-free survival was 8.8months (95 % CI 0–20.3months), and the median overall survival was 40.6months (95 % CI 22.6–58.6months).
- Patients with B cell tumors who relapsed but had no B symptoms were clinical stage I/II, had infiltration fewer than two extranodal sites, had CD4+ counts >200cells/µL, and had lactate dehydrogenase (LDH) less than the upper limit of normal benefited from GDP.
- The level of LDH had a significant impact on the response rate to chemotherapy with GDP (P=0.015).
- Myelosuppression was the main side effect; the incidence of grade 3–4 anemia was 8.3 %; leukopenia, 37.5 %; and thrombocytopenia, 48.3 %.
- Univariate and multivariate analyses were performed to determine variables for OS and PFS.