Department of Hematology, Instituto Mexicano del Seguro Social, MexicoFulltext PDF
Background: Treatment in patients with relapse Extranodal Marginal Zone Lymphoma (EMZL), remain unsolved, because this group of lymphoma, have a longer evolution, relapses are common, and the use of chemotherapy will be considered that can be associated with excessive toxicities, and even if complete response are obtained the risk of subsequent relapses will be considered.
Aims: We performed an clinical trial, phase II, employed low doses of thalidomide, dexamethasone and rituximab, in first relapse in patients with MZL, previously treated with radiotherapy alone, to search if the regimen is well tolerated and response and outcome will be benefit.
Methods: Patients with pathological confirmation of relapse EMZL, age >18 years old, with no upper limit, no gender differences, performed status, <2, and without use of chemotherapy, were included. They received 6 cycles of 28 days, thalidomide 200 mg, standard dose, days 1 to 21, dexamethasone 40 mg, oral, days 1 and 2, rituximab 375 mg/m2, day 1. Response evaluation was performed at 3, 6 and 9 months.
Results: Forty-two patients were included, response was improved between 3 and 9 months, final overall response rate were observed in 41 (97.6%) patients, and complete response in 40 (92.2%). Four patients relapse, actuarial curves at 5-years show progression-free survival was 89.4%: Actuarial curves at 5-years show that progression-free survival were 89.47 (95% Acute toxicities were minimal and well controlled, no late adverse events has been observed).
Conclusion: We show that the use of an low-toxic regimen in relapse MZL, response is very well and outcome were excellent, thus, we believed that the use of aggressive chemotherapy will not been considered as an adequate treatment in this special stings of patients.
Aviles A. Is Necessary the Use of Aggressive Chemotherapy in Relapsed Extranodal Marginal Zone Lymphoma Patient. Clin Oncol. 2022;7:1935..