Which chemotherapy combination causes less kidney damage to patients with non-Hodgkin lymphoma?

This study compared two chemotherapy combinations – R-DHAP and R-DHAOx – to see which caused less kidney damage in patients with non-Hodgkin lymphoma (NHL). The results showed that fewer patients receiving R-DHAOx developed poor kidney function than patients receiving R-DHAP.

Combinations of chemotherapy drugs are often used to treat patients with non-Hodgkin lymphoma (NHL). Different combinations cause different side effects, such as kidney damage. It is important to prevent kidney damage in patients with a higher risk of kidney problems. 

R-DHAP (rituximab, cisplatin, dexamethasone, and cytarabine) is a standard chemotherapy combination for NHL. However, it can cause kidney side effects in patients. Cisplatin (Platinol) is replaced with oxaliplatin (Eloxatin) in the R-DHAOx combination to reduce kidney damage. It is important to confirm that R-DHAOx protects patients from kidney damage compared to R-DHAP.

Data from 58 patients with NHL were analyzed. 35 patients received R-DHAOx and 23 received R-DHAP.  

After 1 cycle, side effects in the kidney were reported in 68% of patients who received R-DHAP and 7.7% of patients who received R-DHAOx. 6 patients in the R-DHAP group switched to R-DHAOx because of kidney side effects.

Both chemotherapy combinations gave similar results. 36.4% of patients receiving R-DHAP and 40% of patients receiving R-DHAOx had no sign of cancer by the end of treatment. 22.7% of patients receiving R-DHAP and 25.7% of patients receiving R-DHAOx had a significant reduction in cancer by the end of treatment.

Similar numbers of patients experienced other side effects in both treatment groups. 66% of patients receiving R-DHAP and 63.7% of patients receiving R-DHAOx developed severe blood-related side effects. 61.2% of patients receiving R-DHAP and 43.3% of patients receiving R-DHAOx required a blood transfusion.

The authors concluded that R-DHAOx causes fewer kidney side effects compared to R-DHAP. in patients with NHL

This study used data from medical records and patients who received R-DHAP did so earlier than R-DHAOx. This may mean that treatment doses have improved in the meantime.