Modified Outpatient Dexamethazone, Cytarabine and Cisplatin Regimen May Lead to High Response Rates and Low Toxicity in Lymphoma

Objective: Our purpose was to investigate the efficacy of and establish a toxicity profile for a modified regimen of dexamethasone, cytarabine and cisplatin (DHAP) for lymphoma outpatients. Subjects and Methods: Fifty-one lymphoma patients, 26 with Hodgkin’s disease and 25 with non-Hodgkin’s lymphoma, were included. The patients’ median age was 32 years (range: 17–61). Twenty had progressive/refractory disease and 31 relapsed disease. Twenty-five were in clinical stage I/II and 26 in clinical stage III/IV before the initiation of salvage chemotherapy. DHAP consisted of dexamethasone (40 mg i.v. on days 1–4), cytarabine (2 g/m2 i.v. as 3-hour infusion on days 2 in the evening and 3 in the morning) and cisplatin (35 mg/m2 as 2-hour infusion on days 1–3) were administered every 21 days. A total of 154 cycles of modified DHAP were administered, with a median of 3 cycles per patient (range: 2–4). Results: The main toxicity was myelosuppression. WHO grade III–IV neutropenia and grade III–IV thrombocytopenia were observed in 27 (52.9%) and 21 (41%) patients, respectively. The overall response rate (85% for Hodgkin’s disease and 95% for non-Hodgkin’s lymphoma) was 88.3% (39.2% complete response and 49.1% partial response). Conclusion: The results showed that this outpatient schedule of DHAP was well tolerated and an effective salvage regimen.