Efficacy of carboplatin with an MEP (mitoxantrone, etoposide and prednisone) regimen for relapsed and CHOP-resistant diffuse large B-cell lymphomas

Abstract 

Mitoxantrone, etoposide and prednisone (MEP)-based regimens using granulocyte colony-stimulating factor (G-CSF) were designed for relapsed and CHOP-resistant diffuse large B-cell lymphomas in a single institution, and the therapeutic effects and adverse reactions were studied. In a total of 49 patients, the MEP regimen had a 41% (9/22) overall response rate compared with 48% (13/27) for the MEP plus carboplatin (C-MEP) regimen (Chi-squared test, P=0.602). Among 38 CHOP-resistant patients, however, the overall response rate to C-MEP [42% (10/24)] was significantly superior compared with MEP [7% (1/14)] (P=0.023), and the overall survival to C-MEP was superior compared with MEP (P=0.088). Taken together, our results, although non-randomized, suggest that a combination of MEP with carboplatin is better than MEP alone in CHOP-resistant diffuse large B-cell lymphomas.

Keywords:  Diffuse large B-cell lymphomas, CHOP-resistance, Salvage therapy, MEP regimen, Carboplatin, C-MEP regimen

Abbreviations:  CI, confidence interval, C-MEP, MEP plus carboplatin, CR, complete response, G-CSF, granulocyte colony-stimulating factor, H, high, IPI, international prognostic index, I–H, intermediate–high, MDR, multi-drug resistance, MEP, mitoxantrone, etoposide and prednisone, NHL, non-Hodgkin's lymphoma, OS, overall survival, PR, partial response