Clinical Outcomes of Patients with Relapse and Refractory Non-Hodgkin’s Lymphoma Treated by DHAOx Regimen

【Objective】 To evaluate the clinical efficacy and side effects of DHAOx ± R regimen in the patients with relapsed and refractory non-Hodgkin's lymphoma (NHL). 【Methods】 Twenty patients with relapsed or refractory NHL were enrolled into this study in Cancer Center of Sun Yat-sen University. These patients were treated with DHAOx ± R regimen (Dexamethasone 20 mg/day intravenous (Ⅳ) on day 1 to day 4, cytarabine 2 000 mg/m2 3 h Ⅳ, every 12 hours on day 2; oxaliplatin 130 mg/m2 2 h Ⅳ on day 1; with or without rituximab 375 mg/m2 on day 0). Six patients were followed by high dose chemotherapy with autologous peripheral blood stem cell transplantation. Response to treatment was assessed according to The International Working Group Criteria,including CR, PR, SD and PD. Side effects were graded according to WHO criteria, including 0-IV grades. 【Results】 Twenty patients received 47 cycles chemotherapy, 13 patients(65%)received DHAOx chemotherapy and 7(35%)received DHAOx + R. The response rate (RR) for the whole group was 55% (11/20) with comeplete response (CR) rate 35% (7/20). The response can also be obtained in the patients who were already treated by platinum-based regimen before. The major toxicity was myelosuppression. The incidence of grade Ⅲ～Ⅳ neutropenia was 35%(16/47), and febrile neutropenia was 17 %(8/47). The incidence of grade Ⅲ～Ⅳ thrombocytopenia was 20%(9/47). Eight cycles (17%) occurred mild neurotoxicity. With median follow-up of 12 months, 1 and 2-year overall survival rate were 70.6%. 【Conclusion】 DHAOx was an effective regimen for recurrent and relapsed NHL patients with mild side effects and further investigation is needed.