Gemcitabine Rituximab Dexamethasone and Thalidomide as Maintenance in the Treatment of Relapse/Refractory Diffuse Large B-cell Lymphoma

Abstract

Background: Although greater advances has been achieved in the treatment of diffuse large B-cell lymphoma, only 35-54% of patients can achieved longer survival. Multiple studies has been performed in the treatment of relapse/refractory lymphoma including stem cell transplant that can offered only in an reduce group patients. Complete response can been observed in 34-56%, but refractory/relapse remain as a problem. We developed an gemcitabine based regimen, that including dexamethasone and rituximab, and thalidomide. Taking in consideration that relapse is frequent, we adding thalidomide at low doses for 18 months as maintenance therapy an low doses. Results: Complete response was achieved in 113 patients (80.7%); actuarial curves at 5 years in maintenance group was 72.95% that was better that control group: 48,5% (p<0.01), overall survival was 68,5% and 41.2%, respectively (p<0.01). Toxicity were minimal and well tolerated. Conclusion: The use of gemcitabine, dexamethasone, rituximab and thalidomide