Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey.
Med Princ Pract. 2010;19(5):344-7. doi: 10.1159/000316370. Epub 2010 Jul 14.
Our purpose was to investigate the efficacy of and establish a toxicity profile for a modified regimen of dexamethasone, cytarabine and cisplatin (DHAP) for lymphoma outpatients.
Fifty-one lymphoma patients, 26 with Hodgkin's disease and 25 with non-Hodgkin's lymphoma, were included. The patients' median age was 32 years (range: 17-61). Twenty had progressive/refractory disease and 31 relapsed disease. Twenty-five were in clinical stage I/II and 26 in clinical stage III/IV before the initiation of salvage chemotherapy. DHAP consisted of dexamethasone (40 mg i.v. on days 1-4), cytarabine (2 g/m(2) i.v. as 3-hour infusion on days 2 in the evening and 3 in the morning) and cisplatin (35 mg/m(2) as 2-hour infusion on days 1-3) were administered every 21 days. A total of 154 cycles of modified DHAP were administered, with a median of 3 cycles per patient (range: 2-4).
The main toxicity was myelosuppression. WHO grade III-IV neutropenia and grade III-IV thrombocytopenia were observed in 27 (52.9%) and 21 (41%) patients, respectively. The overall response rate (85% for Hodgkin's disease and 95% for non-Hodgkin's lymphoma) was 88.3% (39.2% complete response and 49.1% partial response).
The results showed that this outpatient schedule of DHAP was well tolerated and an effective salvage regimen.
我们旨在研究改良地塞米松、阿糖胞苷和顺铂（DHAP）方案治疗淋巴瘤门诊患者的疗效，并建立其毒性谱。
共纳入 51 例淋巴瘤患者，其中 26 例为霍奇金病，25 例为非霍奇金淋巴瘤。患者的中位年龄为 32 岁（范围：17-61 岁）。20 例为进展/难治性疾病，31 例为复发疾病。在开始挽救性化疗前，25 例处于临床 I/II 期，26 例处于临床 III/IV 期。DHAP 方案包括地塞米松（第 1-4 天静脉注射 40mg）、阿糖胞苷（第 2 天晚上和第 3 天上午静脉注射 2g/m2，持续 3 小时）和顺铂（第 1-3 天静脉注射 35mg/m2，持续 2 小时），每 21 天给药 1 次。共给予 154 个周期的改良 DHAP，中位每个患者 3 个周期（范围：2-4 个）。
主要毒性为骨髓抑制。27 例（52.9%）和 21 例（41%）患者分别出现 WHO 分级 III-IV 级中性粒细胞减少和 III-IV 级血小板减少。总体缓解率（霍奇金病为 85%，非霍奇金淋巴瘤为 95%）为 88.3%（完全缓解率为 39.2%，部分缓解率为 49.1%）。
结果表明，这种 DHAP 门诊方案具有良好的耐受性和有效性，是一种有效的挽救性方案。
