ESHAP is an active regimen for relapsing Hodgkin's disease

Abstract

ESHAP is an active regimen for relapsing Hodgkin's disease, with myelosuppression as its dose-limiting toxicity. An increased risk of treatment-related mortality when it is combined with high-dose chemotherapy can not be ruled out.

Intermediate dose gemcitabine–cisplatin combination chemotherapy without treatment delay for cytopenia followed by autografting—a new standard of care in relapsed or refractory Hodgkin lymphoma?

“…The regimen is designed for patients intended to proceed to autografting and the long-term efficacy and toxicity of giving a higher number of cycles without autograft, an approach reported with other gemcitabine/cisplatin combination regimens has not been evaluated. In comparison to the most commonly used UK salvage regimen (ESHAP), GemCis has a superior response rate (overall response 94% in our series vs. 60%), comparable toxicity (53% grade III/IV haematological toxicity in our series vs. 59% grade III/IV) [3] and lower cost.…”

“…Many regimens have been reported, often containing a platinum-based agent, but no single regimen has emerged as the accepted standard. Table 2 provides a summary of commonly used salvage regimens [3,[13][14][15][16][17][18]. All of these have inferior or comparable response rates to those reported here and where data is given the haematological toxicity is generally comparable or higher.…”

“…The cost of GemCis and ESHAP are compared based on a recent study of ESHAP in relapsed or refractory Hodgkin lymphoma [3] ( Table 3). The source for each cost is identified in the table.…”

“…The best treatment for most of these patients is salvage chemotherapy followed by autologous stem cell transplant. Many salvage regimens are used, usually platinum-based, with the most commonly used regimen in the UK being etoposide, methylprednisolone, high dose cytarabine and cisplatin (ESHAP) [3,4]. These regimens have response rates of 60-85% [5], considerable toxicity and may require hospitalisation either for administration or to manage complications.…”

Primary Resistant Course and Recurrence of the Hodgkin,s Lymphoma. Preventable Losses at “Most Recoverable” Hemoblastosis

“…С целью ин-дукции традиционно наиболее часто используются следующие условно выделяемые группы режимов: вы-сокоинтенсивные режимы 2-й линии (по набору цито-статиков совпадающие с наиболее используемым ре-жимом кондиционирования) -режимы mini-BEAM и dexa-BEAM [65,66]; платиносодержащие режимы (ESHAP, DHAP, ASHAP) и/или ифосфамидсодержа-щие режимы (ICE, MINE) [45, 67,68]. В последние годы все более активно стали использоваться режимы на основе новых цитостатиков: гемцитабина, винорел-бина, оксалиплатина.…”