In a nutshell
The authors investigated the use of carboplatin instead of cisplatin in the DHAP chemotherapy regimen. The authors concluded that carboplatin is less toxic than cisplatin, and may be a good substitute.
Some background
Non-Hodgkin lymphomas (NHLs) include all types of lymphoma except for Hodgkin lymphoma (HL). There are many different types of NHL. First-line treatment varies depending on the type of NHL. If first-line therapy fails, DHAP chemotherapy is used.
DHAP (cisplatin, dexamethasone, and cytarabine) chemotherapy is a very common second line therapy for patients with all types of NHL. Cisplatin is very toxic to the body, especially the kidneys. Carboplatin has been considered as a replacement for cisplatin. It is unclear if carboplatin jeopardizes future stem cell transplantation. More research is needed on the side effects and effectiveness of carboplatin.
Methods & findings
This study looked at the effectiveness of DHAP (carboplatin, dexamethasone, and cytarabine) chemotherapy for patients with non-Hodgkin’s and Hodgkin’s lymphoma. The medical records of 199 patients were reviewed. 26 patients had Hodgkin lymphoma (13%). The rest of the patients had different forms of non-Hodgkin’s lymphoma. The most common non-Hodgkin’s lymphomas were diffuse large B cell lymphoma (DLBCL; 107 cases, 54%), mantle cell lymphoma (26 cases, 13%), and follicular lymphoma (23 cases, 12%). The average follow-up time for all patients was 2 years.
The overall survival rate at 2 years (time from treatment to death from any cause) was 89% for the whole group. 144 patients were scheduled to receive a stem cell transplant. 97% of those patients received their scheduled transplant.
The average progression free survival time (time from treatment to disease progression) for patients with DLBCL was 46 months. The average progression free survival time for patients with mantle cell or follicular lymphoma was not reached. After DHAC chemotherapy, 69% of patients had a complete or partial response to the treatment.
The bottom line
The study concluded that carboplatin may be a good substitute for cisplatin in the DHAP chemotherapy treatment, and is less toxic.
Published By :
Annals of Hematology
Date :
Apr 03, 2017
