ABSTRACT
High dose therapy [HDT] with autologous stem-cell transplantation is the treatment of choice for patients with relapsed lymphoma, but is not appropriate for all patients. Effective and less toxic alternatives to conventional salvage regimens are needed. To determine efficacy and safety of gemcitabine, cisplatin and dexamethasone in patients with relapsed or refractory B-cell lymphoma who are not candidates for high dose therapy. Thirty patients with relapsed or refractory B-cell lymphoma were treated with gemcitabine 1000mg/m[2] intravenously [iv] on days 1 and 8, cisplatin 75mg/m[2] iv on day 1, and dexamethasone 40mg/m[2] orally on days 1-4, every 21 days on an outpatient, for a maximum of 6 cycles. The majority [66.7%] had diffuse large B-cell lymphoma. All 30 patients were evaluable for response and toxicity, Five patients [16.7%] achieved complete remission and 12 patients [40%] had partial remission of their disease with an overall response rate of 56.7%. The 2-year progression-free and overall survival rates were 20% and 33.3% respectively. Myelosuppression was the main toxicity. Grade 3 and 4 neutropenia occurred in 40% and 26.7% respectively. Grade 3 and 4 thrombocytopenia occurred in 30% and 23.3% respectively. Only one patient had neutropenic sepsis. Grade 3 non hematological toxicity was minimal with no patients suffered from grade 4 toxicity. Gemcitabine in combination with cisplatin and dexamethasone is an effective and well tolerated salvage regimen in patients with relapsed or refractory B-cell lymphoma who are not eligible for HDT