[NAPD regimen for patients with recurrent refractory diffuse large B-cell lymphoma]

Area of Science:

• Hematology
• Oncology
• Clinical Pharmacology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
• Recurrent or refractory DLBCL presents significant treatment challenges.
• Salvage chemotherapy regimens are crucial for improving outcomes in relapsed patients.

Purpose of the Study:

• To evaluate the clinical efficacy of the NAPD regimen (vinorelbine, cytarabine, cisplatin, dexamethasone) in patients with recurrent/refractory DLBCL.
• To assess the toxicity profile and adverse events associated with the NAPD regimen.
• To analyze survival outcomes, including overall survival (OS) and progression-free survival (PFS).

Main Methods:

• Retrospective study of 30 patients with recurrent/refractory DLBCL.
• NAPD regimen administered for 2 cycles, with efficacy assessed post-treatment.
• Toxicities evaluated after 1 cycle.
• Analysis of objective response rate (ORR), OS, PFS, and survival rates at 1, 2, and 4 years.
• Univariate analysis for prognostic evaluation.

Main Results:

• Objective response rate (ORR) was 56.7% after 2 cycles; clinical benefit rate (CBR) was 83.3%.
• Median OS was 22 months, with 1, 2, and 4-year OS rates of 59.1%, 48.2%, and 40.2%, respectively.
• Median PFS was 14 months, with 1, 2, and 4-year PFS rates of 56.3%, 42.2%, and 31.7%, respectively.
• Myelosuppression was the primary toxicity; no grade III-IV cardiac, liver, or kidney damage observed.

Conclusions:

• The NAPD regimen demonstrates significant clinical efficacy in treating recurrent/refractory diffuse large B-cell lymphoma.
• The regimen is well-tolerated, with manageable toxicities, primarily myelosuppression.
• NAPD represents a promising salvage chemotherapy option warranting further investigation.