Evaluating high-dose cyclophosphamide for patients with hard-to-treat B-cell non-Hodgkin’s lymphoma

This study evaluated the safety and effectiveness of high-dose cyclophosphamide (Cytoxan) for the treatment of relapsed or unresponsive non-Hodgkin’s lymphoma (NHL). This study concluded that high-dose cyclophosphamide was safe and effective for these patients.

Chemotherapy regimens remain a standard treatment option for patients with NHL. High-dose chemotherapy is commonly used before stem cell transplants. Because of the higher dose, this type of chemotherapy has a greater anti-tumor effect. For some patients, this can be more effective as a single dose rather than several lower doses of treatment spread over several days.

Cyclophosphamide is a chemotherapy drug. It is commonly used in combination with other chemotherapy drugs, but it can also be used as a single agent. Whether high-dose cyclophosphamide is safe and effective for patients with relapsed or unresponsive NHL is under investigation.

This study had 42 patients with NHL that came back or stopped responding to treatment. On average, patients had 4 prior lines of therapy. In this study, patients were given at least 1 cycle of high-dose cyclophosphamide. Those who responded to treatment then received another cycle.

Overall, 45% of patients responded to treatment. 43% of all patients had tumor shrinkage. 1 patient had no signs of cancer after treatment.

12.2% of patients were still alive 2 years later. Patients who responded to treatment survived for significantly longer than patients who did not respond to treatment (7.9 months vs. 6.2 months). Patients who had previous chemotherapy at least 6 months before study treatment survived significantly longer than patients who had chemotherapy in the last 6 months (6.1 months vs. 2.6 months).

All patients experienced serious blood-related side effects. 90% (38 patients) had severely low white blood cell count. 64% of patients had seriously low platelet count (cells involved in blood clotting). 57% of patients had low red blood cell count. 43% of patients had other serious side effects. The most common of these were low sodium levels in the blood (31%), infections and fatigue (12% each), and nausea or vomiting (5%).

This study concluded that high-dose cyclophosphamide may be effective for patients with hard-to-treat relapsed NHL. The authors suggest that this regimen could serve as a bridge to cell therapy, such as CAR-T cell therapy.

This was a small study. Larger studies are needed to confirm these results.