›› 2017, Vol. 37 ›› Issue (6): 752-.doi: 10.3969/j.issn.1674-8115.2017.06.007

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Efficacy and prognostic analysis of ICE regimen for 84 patients with relapsed/refractory diffuse large B-cell lymphoma

ZHAO Bing-bing1*, ZHANG Mu-chen2*, HAO Jie3, LIU Zhen-yu3, XIONG Hong1, ZHAO Wei-li2, WANG Li2   

  1. 1. Associated Hematological Department of Ruijin Hospital (Central Hospital of Xuhui District), Shanghai 200031, China; 2. Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200025, China; 3. Department of Hematology, Beizhan Hospital, Shanghai 200070, China
  • Online:2017-06-28 Published:2017-07-05
  • Supported by:

    National Natural Science Foundation of China, 81325003, 81520108003, 81670716, 81201863; Shanghai Excellent Young Medical Talents Training Funding Program; Shanghai Municipal Education Commission–Gaofeng Clinical Medicine Grant Support, 20152206, 20152208; Project of Shanghai Science and Technology Committee, 14430723400, 14140903100, 16JC1405800; Jing-an District Health Research Project, 2016MS11; Xuhui District Central Hospital Research Project, 2014XHYY-04; SMC-Morningstar Young Scholars Program

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Abstract:

 Objective · To evaluate the efficacy and prognostic factors of ifosfamide-cisplatin-etoposide (ICE) chemotherapy as salvage regimen for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).  Methods · A retrospective analysis was performed on 84 relapsed/refractory DLBCL patients who were treated with ICE salvage regimen at Ruijin Hospital (Shanghai Jiao Tong University School of Medicine, China) from July 2004 to June 2016. Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate Cox proportional hazards models.  Results · Of the 84 patients who were treated with ICE regimen, 37 (44.0%) patients had responses, including 26 (31.0%) achieving complete remission. The median number of cycles per patient was 3 (range 1-6 cycles). The 1-year and 2-year OS rates were 49.5% and 30.0%, respectively. The median OS time was 12.2 months. On univariate analysis, patients with early progression/recurrence (P=0.041) and a high-intermediate/high risk according to the international prognostic index (IPI) (P=0.024) and NCCN-IPI (P=0.002) had poorer outcomes. While improved outcome was found in patients in complete remission after chemotherapy (P=0.000). The multivariate analysis revealed that the intermediate-high/high risk according to NCCN-IPI was an independent risk factor, and remission after chemotherapy was an independent prognostic factor for prolonging survival.  Conclusion · The ICE regimen can be used as an effective salvage therapy for patients with relapsed/refractory DLBCL.

Key words: relapsed/refractory diffuse large B-cell lymphoma, prognosis, salvage regimens, ICE chemotherapy