Dexamethasone, oxaliplatin and cytarabine (R-DHAOx) as salvage and stem cells mobilizing therapy in relapsed/refractory diffuse large B cell lymphomas

Abstract

Cisplatin-containing salvage regimens followed by autologous hematopoietic stem cell (HSC) transplantation are the current standard of care for relapsed or refractory (R/R) lymphomas. We retrospectively analyzed efficacy and stem cell mobilizing activity of oxaliplatin, cytarabine, dexamethasone and rituximab (R-DHAOX) in 53 R/R diffuse large B cell lymphomas (DLBCL) treated in our centre (median lines 2, range 2-5; median age 59, range 22-79). Hematological toxicity was manageable and no patients experienced renal impairment. After 2 courses the overall response rate was 60% (CR 49%, PR 11%). Median overall survival (OS) was 30.53 months (95% CI 11.5-49.55), 3year OS 40.5%. Twenty-two eligible patients collected HSC and transplantation was performed in 21/22 patients (95%), after a median of 52 days from last cycle. Our results suggest that in DLBCL R-DHAOX has an excellent stem cell mobilizing capability, response rate comparable to cisplatin-containing regimens and good toxicity profile.

Obinutuzumab does not improve complete methabolic response but does not compromise mobilization or engraftment of autologous peripheral blood stem cells in diffuse large B cell lymphoma: Results from a fondazione italiana linfomi prospective phase II study (the GIOTTO study)

“…We found that, out of 19 patients that underwent the mobilization procedure, 18 achieved an adequate number of CD34 + cells for ASCT. Only 1 patient (5%) failed mobilization, which was the identical rate observed in historical results with the R‐DHAP regimen 24 . No patients required plerixafor, an antagonist of the alfa chemokine receptor, CXCR4.…”

“…Only 1 patient (5%) failed mobilization, which was the identical rate observed in historical results with the R-DHAP regimen. 24 No patients required plerixafor, an antagonist of the alfa chemokine receptor, CXCR4. The average number of CD34 + cells collected was 5.525 � 10 6 /kg, which was sufficient for transplantation.…”

How to manage lymphoid malignancies during novel 2019 coronavirus (CoVid-19) outbreak: a Brazilian task force recommendation

“…In the relapsed setting, patients also usually need immediate salvage. Outpatient regimens such as gemcitabine-based regimens, with rituximab, gemcitabine, cisplatin and dexamethasone (R-GDP), 13 or oxaliplatin-based, with rituximab, dexamethasone, cytarabine and oxaliplatin (R-DHAOX), 14 should be considered. The autologous stem-cell transplant (ASCT) should not be delayed, except in critical cases, due to the risk of progression and the need for more treatment.…”

Left-sided primary cardiac lymphoma: a case report

“…The patient was immediately started on the salvation protocol R-DHAOX (rituximab dexamethasone cytarabine oxaliplatin) [15] but died of septic shock 10 months after the initial presentation and after the fourth cycle of the second-line chemotherapy.…”