Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023;55(2):2261109.
doi: 10.1080/07853890.2023.2261109. Epub 2023 Sep 25.

Efficacy of ESHAP versus ICE plus dexamethasone (DICE) as salvage chemotherapy for relapsed or refractory diffuse large B-cell lymphoma

Pattamaporn Boonlerd  1 , Adisak Tantiworawit  1 , Lalita Norasetthada  1 , Chatree Chai-Adisaksopha  1 , Teerachat Punnachet  1 , Nonthakorn Hantrakun  1 , Pokpong Piriyakhuntorn  1 , Thanawat Rattanathammethee  1 , Sasinee Hantrakool  1 , Ekarat Rattarittamrong  1
Affiliations

Efficacy of ESHAP versus ICE plus dexamethasone (DICE) as salvage chemotherapy for relapsed or refractory diffuse large B-cell lymphoma

Pattamaporn Boonlerd et al. Ann Med. 2023.

Abstract

Objectives: To compare the efficacy and side effects of salvage chemotherapy between etoposide, methylprednisolone, cytarabine and cisplatin (ESHAP) and ifosfamide, carboplatin and etoposide plus dexamethasone (DICE) for relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

Methods: Medical records of patients with relapsed or refractory DLBCL receiving second-line ESHAP or DICE chemotherapy with or without rituximab from January 2007 to November 2022 were retrospectively reviewed. The primary objective was progression-free survival (PFS). The secondary objectives were overall survival (OS), overall response rate (ORR) and adverse events (AEs).

Results: Seventy patients were enrolled including 21 patients who received ESHAP and 49 patients who received the DICE regimen. Six patients (28.6%) and 19 patients (38.8%) in the ESHAP and DICE groups underwent ASCT, respectively. The ORR was 47.6% for ESHAP and 53.1% for DICE (p = .67). The two-year PFS was 14.3% for ESHAP and 26.5% for DICE (p = .33) with median PFS of 5 months and 14 months, respectively (hazard ratio 0.74; 95% CI 0.39-1.36, p = .330). The two-year OS was 14.3% for ESHAP and 26.5% for DICE (p = .37) with median OS of 8 months and 19 months, respectively. Patients in ESHAP group have more all-grade renal impairment than DICE group (23.8% vs. 6.1%, p = .047).

Discussion and conclusions: Efficacy between ESHAP and DICE regimens as salvage chemotherapy for relapsed or refractory DLBCL was not significantly different in terms of two-year PFS, two-year OS and ORR. DICE regimen had less renal AE than ESHAP.

Keywords: DICE chemotherapy; ESHAP chemotherapy; ICE chemotherapy; Relapsed or refractory diffuse large B-cell lymphoma; diffuse large B-cell lymphoma; lymphoma.

PubMed Disclaimer

Conflict of interest statement

The authors report there are no competing interests to declare.

Figures

Figure 1.
Figure 1.
Kaplan–Meier’s curve of progression-free survival according to salvage chemotherapy.
Figure 2.
Figure 2.
Kaplan–Meier’s curve of overall survival according to salvage chemotherapy.
Figure 3.
Figure 3.
Response rate of salvage chemotherapy.
Figure 4.
Figure 4.
Kaplan–Meier’s curve of overall survival according to autologous stem cell transplantation (ASCT) status.
Figure 5.
Figure 5.
Subgroup analysis for progression-free survival.
Figure 6.
Figure 6.
Subgroup analysis for overall survival.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Sehn LH, Salles G.. Diffuse large B-cell lymphoma. N Engl J Med. 2021;384(9):1–9. doi: 10.1056/NEJMra2027612. - DOI - PMC - PubMed
    1. Coiffier B, Lepage E, Briere J, et al. . CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002;346(4):235–242. doi: 10.1056/NEJMoa011795. - DOI - PubMed
    1. Philip T, Guglielmi C, Hagenbeek A, et al. . Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med. 1995;333(23):1540–1545. doi: 10.1056/NEJM199512073332305. - DOI - PubMed
    1. Zelenetz AD, Hamlin P, Kewalramani T, et al. . Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin’s lymphoma. Ann Oncol. 2003;14(Suppl. 1):i5–i10. doi: 10.1093/annonc/mdg702. - DOI - PubMed
    1. Kewalramani T, Zelenetz AD, Nimer SD, et al. . Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma. Blood. 2004;103(10):3684–3688. doi: 10.1182/blood-2003-11-3911. - DOI - PubMed

MeSH terms

LinkOut - more resources