Minimal renal toxicity after Rituximab DHAP with a modified cisplatin application scheme in patients with relapsed or refractory diffuse large B-cell lymphoma.
BACKGROUND
Rituximab (R) in combination with DHAP is a widely accepted salvage regimen for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). A common adverse effect of this protocol is renal toxicity which may result in treatment discontinuation. Assuming that a lower single dose of cisplatin over several days would reduce renal toxicity, our institution has chosen to administer cisplatin in a dosage of 25 mg/m(2) per day as a 3-h infusion over 4 consecutive days.


METHODS
In this study, we analyzed the renal function of 122 patients with relapsed or refractory DLBCL treated with R-DHAP at our institution. Overall, 256 R-DHAP cycles were administered. 31 (25%), 61 (50%), 14 (12%) and 16 (13%) patients received one, two, three or four R-DHAP courses, respectively.


RESULTS
A glomerular filtration rate (GFR) decrease was observed after each R-DHAP cycle. However, in none of the subgroups the median GFR was lower than 60 ml/min/1.73 m(2). In most patients, only renal impairment stage I and II was observed. Renal impairment stage III was seen in 10% and stage IV only in 1% of patients.


CONCLUSION
We conclude that a modified R-DHAP regimen with administration of cisplatin 25 mg/m(2) over 4 consecutive cycles leads only to minimal renal toxicity.
['Lisenko|K|K|', 'McClanahan|F|F|', 'Schöning|T|T|', 'Schwarzbich|M A|MA|', 'Cremer|M|M|', 'Dittrich|T|T|', 'Ho|A D|AD|', 'Witzens-Harig|M|M|']
D000328:Adult D000368:Aged D000971:Antineoplastic Combined Chemotherapy Protocols D002945:Cisplatin D005260:Female D005919:Glomerular Filtration Rate D006801:Humans D016403:Lymphoma, Large B-Cell, Diffuse D008297:Male D008875:Middle Aged D009364:Neoplasm Recurrence, Local D009367:Neoplasm Staging D012074:Remission Induction D000069283:Rituximab D016896:Treatment Outcome
DLBCL R-DHAP Renal chemo toxicity