ESHAP versus IEV Chemotherapy for Relapsed or Refractory Hodgkin's and Non- Hodgkin's Lymphoma

<b>Background:</b> High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) in cases of relapsed or refractory disease. Various salvage chemotherapy regimens have been introduced with specific response rates, toxicity profiles, costs, and stem cell damage before stem cell harvest. The optimal salvage regimen for these patients is unclear. <b>Materials and Methods</b> <b>:</b> In this retrospective analysis, 276 patients with HL and NHL with relapsed or refractory disease after initial treatment that received ESHAP (etoposide, methylprednisolone, cytosine arabinoside, and platinum) or IEV (ifosfamide, epirubicin, etoposide) as salvage regimen were included. We aimed to compare the efficacy of these two chemotherapy regimens as a life-saving treatment in recurrent or refractory disease. <b>Results:</b> The mean age of patients was 33.96 ± 12.39 years. Hodgkin's lymphoma accounted for 60.1% and non-Hodgkin lymphoma (DLBCL) accounted for 39.9% of patients. The overall response rate (ORR) was 79.8% (50% complete response (CR)) for patients with Hodgkin lymphoma who received the ESHAP and 85.6% (55.1% CR) for the IEV regimen. Patients with non-Hodgkin's lymphoma who received the ESHAP plus rituximab regimen had an ORR of 60.9% (CR 40.3%), and patients who received the IEV + Rituximab chemotherapy regimen had an ORR of 72.4% (CR 42.4%) (P = 0.03). However, the mortality rate was lower in patients who received the IEV chemotherapy regimen. <b>Conclusion:</b> IEV treatment is superior to ESHAP in patients with recurrent or refractory Hodgkin's and non-Hodgkin's lymphoma.

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Journal
International Journal of Hematology-Oncology and Stem Cell Research
Published
2025-05-03
DOI
https://doi.org/10.18502/ijhoscr.v19i2.18552
Primary Topic
Lymphoma Diagnosis and Treatment
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article
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article

ESHAP versus IEV Chemotherapy for Relapsed or Refractory Hodgkin's and Non- Hodgkin's Lymphoma

Mohammad Reza Ravanbod, Abolfazl Khalafi‐Nezhad, Mani Ramzi, Reza Vojdani et al.
International Journal of Hematology-Oncology and Stem Cell Research
Lymphoma Diagnosis and Treatment
article

ESHAP versus IEV Chemotherapy for Relapsed or Refractory Hodgkin's and Non- Hodgkin's Lymphoma

Mohammad Reza Ravanbod, Abolfazl Khalafi‐Nezhad, Mani Ramzi, Reza Vojdani, Mehdi Dehghani, Shima Dehdashti
article en

Abstract

<b>Background:</b> High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) in cases of relapsed or refractory disease. Various salvage chemotherapy regimens have been introduced with specific response rates, toxicity profiles, costs, and stem cell damage before stem cell harvest. The optimal salvage regimen for these patients is unclear. <b>Materials and Methods</b> <b>:</b> In this retrospective analysis, 276 patients with HL and NHL with relapsed or refractory disease after initial treatment that received ESHAP (etoposide, methylprednisolone, cytosine arabinoside, and platinum) or IEV (ifosfamide, epirubicin, etoposide) as salvage regimen were included. We aimed to compare the efficacy of these two chemotherapy regimens as a life-saving treatment in recurrent or refractory disease. <b>Results:</b> The mean age of patients was 33.96 ± 12.39 years. Hodgkin's lymphoma accounted for 60.1% and non-Hodgkin lymphoma (DLBCL) accounted for 39.9% of patients. The overall response rate (ORR) was 79.8% (50% complete response (CR)) for patients with Hodgkin lymphoma who received the ESHAP and 85.6% (55.1% CR) for the IEV regimen. Patients with non-Hodgkin's lymphoma who received the ESHAP plus rituximab regimen had an ORR of 60.9% (CR 40.3%), and patients who received the IEV + Rituximab chemotherapy regimen had an ORR of 72.4% (CR 42.4%) (P = 0.03). However, the mortality rate was lower in patients who received the IEV chemotherapy regimen. <b>Conclusion:</b> IEV treatment is superior to ESHAP in patients with recurrent or refractory Hodgkin's and non-Hodgkin's lymphoma.

International Journal of Hematology-Oncology and Stem Cell ResearchVol. 19(2)
Shiraz University of Medical Sciences (IR)
Openalex Percentile: Top 86%
Lymphoma Diagnosis and Treatment
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