الفهرس 
EPIDEMIOLOGY OF NHLOnly 14 pages are availabe for public view
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Abstract
Diffuse large B-cell lymphoma (DLBCL) is a type of aggressive non-Hodgkin lymphomas. It accounts for approximately 40% of lymphomas among adults.
Approximately 40-60% of patients with aggressive non-Hodgkin lymphoma (NHL) treated with standard anthracycline-based regimens either fail to achieve a complete response (CR) or relapse after attaining a CR.
High-dose chemotherapy with autologous stem cell transplantation (ASCT) can be curative in a proportion of patients with relapsed or primary refractory disease provided that a complete response (CR) or partial response (PR) can be induced with second-line chemotherapy.
The aim of this study is to assess the antitumour efficacy and tolerability following two regimens of Chemotherapy in refractory / relapsed DLBCL patients.
It was conducted at the clinical Oncology and Nuclear Medicine Department, Ain Shams University, and Al-Maadi Military Hospital Haematology Oncology Department where 30 patients with histological and immunohistochemical diagnosis of DLBCL were enrolled & randomly allocated into one of two arms; arm A to receive R-ICE regimen (Rituximab, Ifosfamide, Carboplatin and Etoposide) & arm B to receive GEM-P regimen (gemcitabine, cisplatin and methylprednisolone).
For the whole series, Complete remission was achieved in 8/23 patients (35%), partial remission in 8/23 patients (35%), minimal response in 2/23 (9%), and progression occurred in 5/23 patients (22%).
Complete response (CR) was achieved in 37.5% of patients in RICE arm & in 33% of patients in GEM-P arm. Partial response was achieved in 50% in arm A and in 27% in arm B. Minimal response was encountered in 13% in arm B.
The overall response rate (ORR) was 87% for arm A & 73% for arms B. Progression was encountered in 12.5% and 26.5% in arms A & B respectively. The differences between arms A & B in response data is statistically non significant.
The 2-year overall survival (OS) rate of the whole series was 57%, 2-year progression-free survival (PFS) was 24% and the 2-year disease-free survival (DFS) was 24%. The 2-year overall survival rate (OS) was lower for GEM-P (arm B) than RICE (arm A); 54% vs. 62% respectively without statistically significant difference (P >0.05).
Progression-free survival (PFS) at 2 years was 25% for arm A and 23% for arm B with P value >0.05.
Toxicities were evaluated in all randomized patients. Both regimes were generally well tolerated. Haematological toxicity was the major toxicity. Nephrotoxicity was remarkable in arm B. No patient died due to treatment-related toxicity.