Minimal renal toxicity after Rituximab DHAP with a modified cisplatin application scheme in patients with relapsed or refractory diffuse large B-cell lymphoma

BMC Cancer
Katharina LisenkoMathias Witzens-Harig

Abstract

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. 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. 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. 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.

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Citations

Apr 10, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Katharina LisenkoPatrick Wuchter
Jan 22, 2018·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Katharina KriegsmannPatrick Wuchter

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