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R‐DHA‐oxaliplatin (R‐DHAOx) versus R‐DHA‐cisplatin (R‐DHAP) regimen in B‐cell lymphoma treatment: A eight‐year trajectory study

Abstract : Background: The R-DHAP regimen (rituximab, cisplatin, dexamethasone, and high-dose cytarabine) is standardly used to treat relapsed Non-Hodgkin lymphoma (NHL). Despite scarce data, cisplatin is frequently substituted with oxaliplatin (R-DHAOx) to avoid nephrotoxicity. We compared nephrotoxicity of cisplatin and oxaliplatin based on creatinine-based trajectory modeling. Methods: All patients with NHL treated by R-DHAP or R-DHAOx in Angers hospital between January 01, 2007, and December 31, 2014, were included. Patients received cisplatin 100 mg/m2 or oxaliplatin 130 mg/m2 (d1) with cytarabine (2000 mg/m2 , two doses, d2), dexamethasone (40 mg, d1-4), and rituximab (375 mg/m2 , d1). Creatinine levels were recorded before each cycle. Individual profiles of trajectories were clustered to detect homogeneous patterns of evolution. Results: Twenty-two patients received R-DHAP, 35 R-DHAOx, 6 switched from R-DHAP to R-DHAOx due to nephrotoxicity. Characteristics of patients were similar between two groups. Patients receiving R-DHAP experienced more severe renal injury than patients receiving R-DHAOx (68% vs. 7.7%, P < .001). Two homogeneous clusters appeared: cluster A, with a majority of R-DHAOx (32, 91.4%), was less nephrotoxic than B, with a majority of R-DHAP (19, 86.4%), with a decreased average serum creatinine level (P < .0001). There were no other differences between clusters. Conclusions: Our study confirms that R-DHAOx regimen causes less nephrotoxicity than R-DHAP regimen.
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Submitted on : Tuesday, December 21, 2021 - 11:21:31 AM
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Carole Lacout, Corentin Orvain, Valérie Seegers, Manon de Vries, Mélanie Mercier, et al.. R‐DHA‐oxaliplatin (R‐DHAOx) versus R‐DHA‐cisplatin (R‐DHAP) regimen in B‐cell lymphoma treatment: A eight‐year trajectory study. European Journal of Haematology, Wiley, 2020, 105 (2), pp.223-230. ⟨10.1111/ejh.13429⟩. ⟨inserm-03498857⟩



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