Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Acta Haematol. 2019;141(2):84-90. doi: 10.1159/000495283. Epub 2019 Jan 10.
Gemcitabine-based salvage therapy is considered an effective treatment for relapsed and refractory Non-Hodgkin's lymphoma (NHL). We analyzed the outcome of 41 consecutive NHL patients treated with gemcitabine-based regimens between January 2007 and October 2015. Twenty-eight males and 13 females (median age 66.4 years) were included. The median follow-up from gemcitabine initiation was 7.3 months. Thirty patients (73%) had B-cell, and eleven (27%) had T-cell, lymphoma. All patients received a median of 2 prior regimens, of which at least 1 was anthracycline based. Twenty-eight patients (78%) received full-dose while 9 (22%) received reduced-dose regimens. The overall response rate was 37%, with 24% (n = 10) complete response, 12% (n = 5) partial response, and 63% (n = 22) progressive disease or stable disease. The median progression-free survival (PFS) was 47 days (range 12-1,318), the median overall survival (OS) was 1.9 years. Twenty patients (49%) died during follow-up. Grade 3-4 hematological toxicity was reported in 21 patients (51%). Relapsed vs. refractory disease, as well as a response to gemcitabine, predicted better PFS and OS. Use of a full-dose regimen predicted a better OS. Compared to previously published data, we observed less favorable outcomes. The administration of gemcitabine-based therapy as a salvage regimen for patients with relapsed or refractory NHL had limited success. Innovative therapies for these patients are an unmet need.
基于吉西他滨的挽救疗法被认为是治疗复发和难治性非霍奇金淋巴瘤（NHL）的有效方法。我们分析了 2007 年 1 月至 2015 年 10 月期间接受吉西他滨为基础方案治疗的 41 例 NHL 患者的结果。28 例男性和 13 例女性（中位年龄 66.4 岁）入组。从吉西他滨开始治疗的中位随访时间为 7.3 个月。30 例（73%）为 B 细胞淋巴瘤，11 例（27%）为 T 细胞淋巴瘤。所有患者接受了中位数为 2 个方案的治疗，其中至少 1 个方案为蒽环类药物为基础的方案。28 例（78%）患者接受全剂量方案，9 例（22%）接受低剂量方案。总缓解率为 37%，完全缓解率为 24%（n=10），部分缓解率为 12%（n=5），进展或疾病稳定率为 63%（n=22）。中位无进展生存期（PFS）为 47 天（范围 12-1318），中位总生存期（OS）为 1.9 年。20 例（49%）患者在随访期间死亡。21 例（51%）患者发生 3-4 级血液学毒性。吉西他滨缓解与疾病复发/难治性以及对吉西他滨的反应相关，与 PFS 和 OS 相关。使用全剂量方案与 OS 改善相关。与之前发表的数据相比，我们观察到不太理想的结果。吉西他滨为基础的挽救疗法作为复发或难治性 NHL 患者的治疗方案效果有限。为这些患者提供创新疗法是一种未满足的需求。
