R-ASHAP regimen for salvage of lymphoma – pro

R-ASHAP chemotherapy is – rituximab, doxorubicine, methylprednisolone, high-dose cytarabine, cisplatin. This is fairly new regimen  with only a few reports of observational studies.

There are no randomized controlled trials comparing different conventional dose salvage chemotherapy regimens (PACEBOM, ESHAP, RICE, IVAC) in people with relapsed aggressive non-Hodgkin’s lymphoma. The consensus is that people with relapsed disease should be treated with salvage chemotherapy. One systematic review identified 22 phase II trials of various conventional dose salvage chemotherapy regimens. All regimens reported similar response rates and no single superior regimen can be identified. There are likewise no studies confirming or disproving the additive effect of Rituximab but it is a well reported regimen and no clinical trials are currently investigating RICE vs ICE chemotherapy.However, it is not proven. A clinical trial (NCT00367497) of R-ESHAP is currently recruiting patients.

B. J. Byrne and J. P. Gockerman Salvage Therapy in Hodgkin’s Lymphoma
Oncologist, February 1, 2007; 12(2): 156 – 167.

J. Rodriguez, M.A. Rodriguez, L. Fayad, P. McLaughlin, F. Swan, A. Sarris, J. Romaguera, B. Andersson, F. Cabanillas, and F.B. Hagemeister
ASHAP: A Regimen for Cytoreduction of Refractory or Recurrent Hodgkin’s Disease
Blood 93: 3632-3636.

Aydin, Semra; Dührsen, Ulrich; Nückel, Holger, Rituximab plus ASHAP for the treatment of patients with relapsed or refractory aggressive non-Hodgkin’s lymphoma: a single-centre study of 20 patients Source: Annals of Hematology, Volume 86, Number 4, April 2007 , pp. 271-276(6)

Hänel M, Kröger N, Hoffknecht MM, Peters SO, Metzner B, Fiedler F, Braumann D, Schubert JC, Illiger HJ, Hänel A, Krüger WH, Zeller W, Weh HJ, Hossfeld DK, Zander AR. ASHAP–an effective salvage therapy for recurrent and refractory malignant Ann Hematol. 2000 Jun;79(6):304-11.

MEHMET AKIF ÖZTÜRK et al,  Modified ESHAP as salvage chemotherapy for recurrent or refractory non-Hodgkin’s lymphoma: Results of a single-center study of 32 patients Chemotherapy  (Chemotherapy)  2002, vol. 48, no5, pp. 252-258

BMJ – CLinical Evidence – http://clinicalevidence.bmj.com/ceweb/conditions/bly/2401/2401_I5.jsp

Kimby E, Brandt L, Nygren P, et al. A systematic review of chemotherapy effects in aggressive non-Hodgkin’s lymphoma. Acta Oncol 2001;40:198–212.

Barosi G, Carella A, Lazzarino M, et al. Management of nodal diffuse large B-cell lymphomas: practice guidelines from the Italian Society of Haematology, the Italian Society of Experimental Haematology and the Italian Group for Bone Marrow Transplantation. Haematologica 2006;91:96–103.


Kimby E, Brandt L, Nygren P, et al. A systematic review of chemotherapy effects in aggressive non-Hodgkin’s lymphoma. Acta Oncol 2001;40:198–212.

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