Analysis of Efficacy of DICE (Dexamethasone, Ifosfamide, Cisplatin and Etoposide) Regimen on Recurrent and Refractory Intermediate and High Grade Non-Hodgkin's Lymphoma

Lei YANG, Zhucheng SONG, Xiaohong XU, Jinzhi WEI, Qinghe TAN, Zhirong CONG, Chunlei PENG

Abstract


OBJECTIVE    Thus far there is no standard salvage regimen for patients with recurrent and refractory intermediate and high grade non-Hodgkin’s lymphoma (NHL). This study intends to investigate the therapeutic efficacy of the DICE (dexamethasone, isofosfamide, cisplatin and etoposide) regimen on the recurrent and refractory NHL, and to observe the related adverse effects.
METHODS    Clinical records of 22 patients with recurrent and refractory NHL, who failed to achieve a remission from the CHOP [cyclophosphamide, hydroxydaunomycin/doxorubicin (adriamycin), oncovin, prednisone] regimen within 2 to 6 cycles of treatment, were reviewed. DICE, as a salvage regimen with a median course of treatment of 4 cycles (ranging from 2 to 7 cycles), was now used, and evaluation of the therapeutic efficacy and adverse eff ect of DICE was conducted in all the patients. Of the 22 NHL cases, 8 were of T-cell origin and the other 14 B-cell origin. Salvage treatment was performed in the patients, with appraisal, prevention and treatment of the toxic reactions.
RESULTS    Following DICE treatment in the 22 patients, the total effective rate of the regimen was 63.6%, and the complete remission (CR) rate was 40.9%. The effective rates of DICE on the T and B-cell sourced NHL were 75.0% and 57.1%, and the CR rate were 37.5%, 42.9%, respectively ( P  > 0.05). An increase of the lactate dehydrogenase (LDH) level accompanied by a giant lump was the short-term effect on patients with recurrence (mean  P  < 0.05) who were drug resistant. Myelosuppression, digestive system reaction and alopecia were the commonly-seen complications in the patients who received DICE regimen. All patients recovered after treatment, and no chemotherapy-related death occurred.
CONCLUSION    DICE regimen is effective in treating refractory and recurrent NHL.

Keywords


Non-Hodgkin’s lymphoma, chemotherapy, DICE regimen, therapeutic effect, adverse effect.

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