Mehrzad Valiollah, Ashrafi Farzaneh, Farrashi Ali Reza, Pourmarjani Reyhaneh, Dehghani Mehdi, Shahsanaei Armindokht
Department of Hematology and Medical Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2017 Mar 7;6:30. doi: 10.4103/2277-9175.201687. eCollection 2017.
Refractory or relapsed Hodgkin's disease (HD) occurs in 10-50% of patients. The treatment of choice for these patients is high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT). Response to salvage chemotherapy (SCT) partial remission (PR) is necessary before HDCT with ASCT. However, its applicability is restricted mostly to patients responding to salvage chemotherapy. Optimal salvage regimen for these patients is unclear. In this study, our aim was to compare the efficacy profiles of ifosfamide, carboplatin, and etoposide (ICE) and etoposide-steroid-cytarabine-cisplatin (ESHAP) (cytosine arabinoside, cisplatin, and dexamethasone) regimens in the salvage treatment of relapsed or refractory HD.
In this retrospective analysis, 114 patients with primary refractory or relapsed HD who received ICE or ESHAP salvage regimen were included.
Of 114 patients, 47 (41.2%) were females and the median age was 31.5 years. Response could be evaluated in 114 patients. Of 114 patients, 38 (33%) achieved complete remission (CR) and 21 (18.4%) achieved PR, leading to an overall response rate (ORR: CR + PR) of 51.4%. In the evaluable ICE group ( = 41), rates of CR, PR, and ORR were 21.9%, 17.1%, and 39% and in the ESHAP group ( = 73), rates of CR, PR, and ORR were 39.7%, 19.2%, and 58.9% (for ORR, = 0.04), respectively.
In patients with relapsed or refractory HD, treatment with ESHAP seems to have higher rates of response than ICE regimen does.
10% - 50%的患者会出现难治性或复发性霍奇金淋巴瘤（HD）。这些患者的首选治疗方法是大剂量化疗（HDCT）和自体干细胞移植（ASCT）。在进行HDCT联合ASCT之前，对挽救性化疗（SCT）达到部分缓解（PR）是必要的。然而，其适用性大多局限于对挽救性化疗有反应的患者。这些患者的最佳挽救方案尚不清楚。在本研究中，我们的目的是比较异环磷酰胺、卡铂和依托泊苷（ICE）方案与依托泊苷 - 类固醇 - 阿糖胞苷 - 顺铂（ESHAP）（阿糖胞苷、顺铂和地塞米松）方案在复发性或难治性HD挽救治疗中的疗效。
在这项回顾性分析中，纳入了114例接受ICE或ESHAP挽救方案的原发性难治性或复发性HD患者。
114例患者中，47例（41.2%）为女性，中位年龄为31.5岁。114例患者的反应可进行评估。114例患者中，38例（33%）达到完全缓解（CR），21例（18.4%）达到PR，总缓解率（ORR：CR + PR）为51.4%。在可评估的ICE组（n = 41）中，CR、PR和ORR率分别为21.9%、17.1%和39%，在ESHAP组（n = 73）中，CR、PR和ORR率分别为39.7%、19.2%和58.9%（对于ORR，P = 0.04）。
在复发性或难治性HD患者中，ESHAP治疗的反应率似乎高于ICE方案。
