EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT

Introduction Gastric Diffuse large B‐cell lymphoma (DLBCL) is the most common extra-nodal site of lymphoma’s involvement (30%-40% of all extranodal lymphomas and 55%-65% of all gastrointestinal lymphomas). However, gastric localizations are also sometimes found in systemic DLBCL. Gastric complicati...

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Main Authors: Luca Guarnera, Federico Meconi, Roberto Secchi, Maria Rosaria Pascale, Fabiana Esposito, Annagiulia Zizzari, Vito Mario Rapisarda, Manuela Rizzo, Livio Pupo, Maria Cantonetti
Format: Article
Language:English
Published: PAGEPress Publications 2022-02-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://mjhid.org/index.php/mjhid/article/view/4784
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author Luca Guarnera
Federico Meconi
Roberto Secchi
Maria Rosaria Pascale
Fabiana Esposito
Annagiulia Zizzari
Vito Mario Rapisarda
Manuela Rizzo
Livio Pupo
Maria Cantonetti
author_facet Luca Guarnera
Federico Meconi
Roberto Secchi
Maria Rosaria Pascale
Fabiana Esposito
Annagiulia Zizzari
Vito Mario Rapisarda
Manuela Rizzo
Livio Pupo
Maria Cantonetti
author_sort Luca Guarnera
collection DOAJ
description Introduction Gastric Diffuse large B‐cell lymphoma (DLBCL) is the most common extra-nodal site of lymphoma’s involvement (30%-40% of all extranodal lymphomas and 55%-65% of all gastrointestinal lymphomas). However, gastric localizations are also sometimes found in systemic DLBCL. Gastric complications such as bleeding, perforation and stenosis under chemotherapy are well documented.  Methods We retrospectively analyzed 15 patients with newly diagnosed DLBCL with gastrointestinal involvement. Endoscopies were performed in these patients before and after treatment. Treatment consisted in cyclophosphamide low-dose pre-phase chemotherapy before conventional-dose chemotherapy. Results Endoscopy at staging detected ulcers in 12 patients (80%). After low-dose pre-phase chemotherapy GI ulcers healed in 91.6% of cases (1 ulcer detected). After the whole treatment (Low-dose pre-phase + chemotherapy) 9 patients (60%) achieved complete response, 4 patients (26.6%) partial response, 2 (13,3%) patients presented disease progression. The most frequent adverse event was neutropenia (73.3%); the most frequent non hematological adverse event was transaminases elevation (20%). Conclusion Cyclophosphamide low-dose pre-phase chemotherapy resulted a safe and effective way to prevent adverse events in systemic DLBCL with gastrointestinal involvement.
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spelling doaj-art-c8949b5e718b4a5fbfe83fd9f88d659f2024-12-02T03:05:25ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062022-02-0114110.4084/MJHID.2022.017EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENTLuca Guarnera0Federico Meconi1Roberto Secchi2Maria Rosaria Pascale3Fabiana Esposito4Annagiulia Zizzari5Vito Mario Rapisarda6Manuela Rizzo7Livio Pupo8Maria Cantonetti9Hematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, ItalyHematology, Department of Biomedicine and Prevention, University Tor Vergara, Rome, Italy Introduction Gastric Diffuse large B‐cell lymphoma (DLBCL) is the most common extra-nodal site of lymphoma’s involvement (30%-40% of all extranodal lymphomas and 55%-65% of all gastrointestinal lymphomas). However, gastric localizations are also sometimes found in systemic DLBCL. Gastric complications such as bleeding, perforation and stenosis under chemotherapy are well documented.  Methods We retrospectively analyzed 15 patients with newly diagnosed DLBCL with gastrointestinal involvement. Endoscopies were performed in these patients before and after treatment. Treatment consisted in cyclophosphamide low-dose pre-phase chemotherapy before conventional-dose chemotherapy. Results Endoscopy at staging detected ulcers in 12 patients (80%). After low-dose pre-phase chemotherapy GI ulcers healed in 91.6% of cases (1 ulcer detected). After the whole treatment (Low-dose pre-phase + chemotherapy) 9 patients (60%) achieved complete response, 4 patients (26.6%) partial response, 2 (13,3%) patients presented disease progression. The most frequent adverse event was neutropenia (73.3%); the most frequent non hematological adverse event was transaminases elevation (20%). Conclusion Cyclophosphamide low-dose pre-phase chemotherapy resulted a safe and effective way to prevent adverse events in systemic DLBCL with gastrointestinal involvement. http://mjhid.org/index.php/mjhid/article/view/4784Low-dose pre-phase chemotherapyDiffuse Large B Cell Lymphoma with gastrointestinal involvementCyclophosphamide
spellingShingle Luca Guarnera
Federico Meconi
Roberto Secchi
Maria Rosaria Pascale
Fabiana Esposito
Annagiulia Zizzari
Vito Mario Rapisarda
Manuela Rizzo
Livio Pupo
Maria Cantonetti
EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT
Mediterranean Journal of Hematology and Infectious Diseases
Low-dose pre-phase chemotherapy
Diffuse Large B Cell Lymphoma with gastrointestinal involvement
Cyclophosphamide
title EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT
title_full EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT
title_fullStr EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT
title_full_unstemmed EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT
title_short EFFICACY AND SAFETY OF CYCLOPHOSPHAMIDE LOW-DOSE PRE-PHASE CHEMOTHERAPY IN DIFFUSE LARGE B CELL LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT
title_sort efficacy and safety of cyclophosphamide low dose pre phase chemotherapy in diffuse large b cell lymphoma with gastrointestinal involvement
topic Low-dose pre-phase chemotherapy
Diffuse Large B Cell Lymphoma with gastrointestinal involvement
Cyclophosphamide
url http://mjhid.org/index.php/mjhid/article/view/4784
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