What are the second-line regimens for high-dose chemotherapy (HDC) for relapse or refractory disease in diffuse large B-cell lymphoma (DLBCL) non-Hodgkin lymphoma (NHL)?

Updated: Jun 12, 2019
  • Author: Priyank P Patel, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

For relapse or refractory disease, high-dose chemotherapy (HDC) and autologous stem cell rescue (ASCR) is the treatment of choice. Before or after HDC and ASCRA, IFRT is given to previous disease sites. Second-line regimens for HDC include the following, which may be given with or without rituximab :

  • DHAP (dexamethasone, cytarabine [high-dose Ara C], cisplatin)

  • ESHAP (methylprednisolone, etoposide, cytarabine, cisplatin)

  • GDP (gemcitabine, dexamethasone, cisplatin)

  • GemOx (gemcitabine and oxaliplatin)

  • ICE (ifosfamide, carboplatin, etoposide)

  • MINE (mitoxantrone, ifosfamide, mesna, etoposide)

Patients with relapsed disease who are not eligible for HDC and ASCR should be enrolled in a clinical trial. If one is not available, they should receive palliative chemotherapy.


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