The effect of the dexamethasone, cytarabine, and cisplatin (DHAP) regimen on stem cell mobilization and transplant outcomes of patients with non-Hodgkin's lymphoma who are candidates for up-front autologous stem cell transplantation.

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Author(s): Jeon SY;Jeon SY;Jeon SY; Yhim HY; Yhim HY; Yhim HY; Kim HS; Kim HS; Kim JA; Kim JA; Yang DH; Yang DH; Kwak JY; Kwak JY; Kwak JY
Source:
The Korean journal of internal medicine [Korean J Intern Med] 2018 Nov; Vol. 33 (6), pp. 1169-1181. Date of Electronic Publication: 2018 Jan 08.
Publication Type:
Comparative Study; Journal Article; Multicenter Study
Language:
English

Additional Information
- Source:
  Publisher: Korean Association of Internal Medicine Country of Publication: Korea (South) NLM ID: 8712418 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2005-6648 (Electronic) Linking ISSN: 12263303 NLM ISO Abbreviation: Korean J Intern Med Subsets: MEDLINE
- Publication Information:
  Original Publication: [Seoul] : Korean Association of Internal Medicine
- Subject Terms:
  Stem Cell Transplantation*/adverse effects ; Stem Cell Transplantation*/mortality; Antineoplastic Agents, Immunological/*administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage ; Granulocyte Colony-Stimulating Factor/*administration & dosage ; Hematopoietic Stem Cell Mobilization/*methods ; Lymphoma, Non-Hodgkin/*therapy ; Rituximab/*administration & dosage; Adolescent ; Adult ; Aged ; Antineoplastic Agents, Immunological/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Chemotherapy-Induced Febrile Neutropenia/etiology ; Cyclophosphamide/administration & dosage ; Cyclophosphamide/adverse effects ; Doxorubicin/administration & dosage ; Doxorubicin/adverse effects ; Female ; Granulocyte Colony-Stimulating Factor/adverse effects ; Hematopoietic Stem Cell Mobilization/adverse effects ; Hematopoietic Stem Cell Mobilization/mortality ; Humans ; Lymphoma, Non-Hodgkin/blood ; Lymphoma, Non-Hodgkin/diagnosis ; Lymphoma, Non-Hodgkin/mortality ; Male ; Middle Aged ; Prednisone/administration & dosage ; Prednisone/adverse effects ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Rituximab/adverse effects ; Time Factors ; Transplantation, Autologous ; Treatment Outcome ; Vincristine/administration & dosage ; Vincristine/adverse effects ; Young Adult
- Abstract:
  Background/aims: Data on dexamethasone, cytarabine, and cisplatin (DHAP) as a mobilization regimen, compared to high-dose cyclophosphamide (HDC), for up-front autologous stem cell transplantation (ASCT) in non-Hodgkin's lymphoma (NHL) is limited.
  Methods: Consecutive patients with aggressive NHL treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab-CHOP who underwent chemomobilization using HDC or DHAP plus granulocyte-colony stimulating factor (G-CSF) for up-front ASCT were enrolled from three institutions between 2004 and 2014.
  Results: Ninety-six patients (57 men) were included. Sixty-five patients (67.7%) received HDC; and 31 (32.3%), DHAP. The total CD34+ cells mobilized were significantly higher in patients receiving DHAP (16.1 vs. 6.1 × 106/kg, p = 0.001). More patients achieved successful mobilization with DHAP (CD34+ cells ≥ 5.0 × 106/kg) compared to HDC (87.1% vs. 61.5%, respectively; p = 0.011), particularly within the first two sessions of apheresis (64.5% vs. 32.3%, respectively; p = 0.003). Mobilization failure rate (CD34+ cells < 2.0 × 106/kg) was significantly higher in patients receiving HDC (20.0% vs. 3.2%, p = 0.032). On multivariate analysis, the DHAP regimen (odds ratio, 4.12; 95% confidence interval, 1.12 to 15.17) was an independent predictor of successful mobilization. During chemomobilization, patients receiving HDC experienced more episodes of febrile neutropenia compared to patients receiving DHAP (32.3% vs. 12.9%, p = 0.043).
  Conclusion: The DHAP regimen was associated with a significantly higher efficacy for stem cell mobilization and lower frequency of febrile neutropenia. Therefore, DHAP plus G-CSF is an effective for mobilization in patients with aggressive NHL who were candidates for up-front ASCT.
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- Contributed Indexing:
  Keywords: Autologous stem cell transplantation; Cyclophosphamide; Dexamethasone, cytarabine, and cisplatin; Lymphoma, non-Hodgkin; Mobilization
- Accession Number:
  0 (Antineoplastic Agents, Immunological)
  143011-72-7 (Granulocyte Colony-Stimulating Factor)
  4F4X42SYQ6 (Rituximab)
  5J49Q6B70F (Vincristine)
  80168379AG (Doxorubicin)
  8N3DW7272P (Cyclophosphamide)
  VB0R961HZT (Prednisone)
- Subject Terms:
  CHOP protocol
- Publication Date:
  Date Created: 20180104 Date Completed: 20190924 Latest Revision: 20190925
- Publication Date:
  20250114
- Accession Number:
  PMC6234385
- Accession Number:
  10.3904/kjim.2016.163
- Accession Number:
  29295612

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The effect of the dexamethasone, cytarabine, and cisplatin (DHAP) regimen on stem cell mobilization and transplant outcomes of patients with non-Hodgkin's lymphoma who are candidates for up-front autologous stem cell transplantation.

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The effect of the dexamethasone, cytarabine, and cisplatin (DHAP) regimen on stem cell mobilization and transplant outcomes of patients with non-Hodgkin's lymphoma who are candidates for up-front autologous stem cell transplantation.

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