ASHAP--an effective salvage therapy for recurrent and refractory malignant lymphomas

Area of Science:

• Oncology
• Hematology
• Pharmacology

Background:

• Recurrent and refractory malignant lymphomas present significant treatment challenges.
• Evaluating novel therapeutic combinations is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the efficacy and toxicity of the ASHAP regimen (adriamycin, methylprednisolone, cytarabine, cisplatin) in patients with relapsed or refractory Hodgkin's disease (HD) and non-Hodgkin's lymphomas (NHL).

Main Methods:

• Sixty-five patients with HD (n=14) or NHL (n=51) received ASHAP therapy.
• The regimen included adriamycin (ADR), methylprednisolone, cytarabine (Ara-C), and cisplatin (CDDP) administered over specific schedules.
• Patients achieving remission underwent high-dose therapy (HDT) with stem cell transplantation.

Main Results:

• An overall response rate of 69% was observed, with 38% achieving complete remission (CR) and 31% partial remission (PR).
• Three-year event-free survival (EFS) was 30% for responders and 21% for all patients; overall survival (OS) at 3 years was 32%.
• The most common toxicities were grade III/IV leukocytopenia and thrombocytopenia (approx. 80%), with rare severe non-hematological side effects and no treatment-related mortality.

Conclusions:

• ASHAP is an effective and moderately toxic salvage chemotherapy for relapsed or refractory HD and NHL.
• Combining ASHAP with HDT and stem cell support demonstrates comparable or improved survival outcomes versus other protocols.
• HDT intensification post-ASHAP appears to enhance survival in responding patients.