GDP(Gemcitabine, platin, dexamethasone) for salvage of Hodgkin’s – pro
Relapsed or refractory Hodgkin lymphoma 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 are no direct comparisons of different salvage combinations and no consensus on the gold-standard second-line chemotherapy. The published randomized controlled trials (RCTs) of ASCT for RR-HL used mini-BEAM (ie, BCNU [bis-chloronitrosourea], etoposide, ara-C, melphalan) or dexa-BEAM (dexamethasone, BCNU, etopoxide, ara-C, melphalan), so some experts think that these regimens should be considered standard regimens in this setting(2). Gemzar/cisplatin/dexamethasone in patients with relapsed Hodgkin’s lymphoma was published in 2003 by Baez et al(1). 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(3) is more liberal and lists GDP (gemcitabine, carboplatin and dexamethasone)as well as other regimesn based solely on phase II studies.
1.Baetz T, Belch A, Couban S, et al. Gemcitabine, dexamethasone and cisplatin is an active and non-toxic chemotherapy regimen in relapsed or refractory Hodgkin’s disease: a phase II study by the National Cancer Institute of Canada Clinical Trials Group. Annals of Oncology. 2003;14:1762-1767.
2.John Kuruvilla, Armand Keating, and Michael Crump, How I treat relapsed and refractory Hodgkin lymphoma Blood (2011) 117(16): 4208-4217
3.NCCN, HODG-E, 2
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