Non Hodgkin Lymphoma: Experience of a Referral Hospital.

Non-Hodgkin lymphomas corresponds a heterogeneous group of neoplasms deriving of lymphocytes, in development countries represents a great cause of morbility and mortality. The General Hospital of Mexico is a referral centre localized in Mexico City, whose first cause of primary hematology attention in NHL.

Is an observational, descriptive and retrospective study, based on medical records of patients treated between 1992-2009.

Determine the response, overall survival (OS) and event free survival (EFS) (progression, death or last visit) associated with treatment by CHOP as first line treatment without rituximab and four cycles of DEP as a second line treatment (dexamethasone 40 mg/m² IV daily, days 1-4, VP-16 300 mg/m² IV daily, days 1-2 and cysplatin 100 mg/m² IV day 1), in cycles of 21 days each one.

In a period of 17 years, 303 of 632 patients were eligible. The average age was 52 years, with male:female relation 1:1.1. Thirty four percent of the sample were older 60 years. The most frequent NHL was diffuse large B cell lymphoma (DLBCL) (N=146 treated), 60% were IPI low plus intermediate low; the most frequent indolent NHL were follicular lymphoma (N=20 treated), 71% were FLIPI low plus intermediate. The resting 94 cases were treated with CHOP, too.

The global trend is the addition of rituximab to all of CHOP-based regimens. In our country, because the economics limitations, the use of rituximab is low. The CHOP regimen remains the first line treatment; and the second line treatments are based on the experience of the institutional protocols. DEP is the institutional protocol for second line treatment and their response, OS and EFS are comparable to more expensive protocols (ESHAP, DHAP). Concluding that DEP is a low toxic and cheaper second line regimen and this could be an alternative for development countries.

No relevant conflicts of interest to declare.