Relapsed or refractory Hodgkin lymphoma, disease that does not respond to chemotherapy or comes back after chemo, is a challenging problem for clinicians who treat hematologic malignancies. The general approach involves salvage chemo and a consideration of stem cell transplantation, if salvage succeeds. Unfortunately, there is not consesnsus as to what salvage combiantions of drugs should be used, becasue there are very few comparisons of different salvage combinations. Many of the published randomized controlled trials of autologous stem cell transplantation used mini-BEAM or dexa-BEAM, so some experts think that these regimens should be considered standard regimens in this settin. Gemzar/cisplatin/dexamethasone in patients with relapsed Hodgkin’s lymphoma was published in 2003 by Baez et a. The trial included 23 patients and overall response rate was nearly 70%; the remaining 30% of patients achieved disease stabilization. No patient experienced progressive disease while being treated with Gemzar/cisplatin/dexamethasone. Toxicity was mild and all patients were able to undergo a subsequent autologous stem cell transplant. NCCN is more liberal and lists GDP (gemcitabine, carboplatin and dexamethasone)as well as other regimesn based solely on phase II studies.
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