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High‐dose cyclophosphamide for hard‐to‐treat patients with relapsed or refractory B‐cell non‐Hodgkin's lymphoma, a phase II result
Author(s) -
Michot JeanMarie,
Annereau Maxime,
Danu Alina,
Legoupil Clémence,
Bertin Louis,
Chahine Claude,
Achab Nadia,
Antosikova Anna,
Cerutti Ariane,
Rossignol Julien,
Ghez David,
Willekens Christophe,
Dartigues Peggy,
Lazarovici Julien,
Lemare Francois,
Ribrag Vincent
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13369
Subject(s) - medicine , cyclophosphamide , lymphoma , refractory (planetary science) , rituximab , mantle cell lymphoma , regimen , gastroenterology , chemotherapy , oncology , surgery , physics , astrobiology
Background High‐dose cyclophosphamide to treat solid refractory tumors demonstrated meaningful activity, while data to treat lymphoma remain scarce. This study aims to assess high‐dose cyclophosphamide to treat relapsed or refractory lymphoma. Methods A phase II study included adult patients with relapsed or refractory B‐cell non‐Hodgkin's lymphoma, previously treated by ≥2 prior lines with no other available option of therapy. High‐dose cyclophosphamide was given intravenously 3 g/m 2 over two consecutive days and repeated once at 28 days in responding patients. Rituximab 375 mg/m 2 intravenously was added in patients not refractory to anti‐CD20 antibody. Results Forty‐two patients with median age 65 [56‐70] years were included. Patients had previously received a median of four lines of therapies. Tumor types were diffuse large B‐cell lymphoma (n = 26; 62%), indolent B‐cell non‐Hodgkin lymphoma (n = 10; 24%), or mantle lymphoma (n = 6; 14%). Hematologic and non‐hematologic grade 3‐5 toxicities occurred in 42 (100%) and 18 (43%) of patients, respectively. The overall response rate was 45%. Conclusion One to two cycles of high‐dose cyclophosphamide in hard‐to‐treat patients with relapsed or refractory B‐cell non‐Hodgkin lymphoma demonstrated a favorable safety and efficacy profile. This regimen could serve as a bridge to modern cellular therapy with CAR‐T cell.