Efficacy and Adverse Reactions of Gemcitabine Combined with Cyclophosphamide, Vinblastine and Prednisone Hydrogenation Regiments in Relapse and/or Refractory Non-Hodgkin's Lymphoma

Objective: To explore the clinical efficacy and adverse reactions of gemcitabine combined with cyclophosphamide, vinblastine and prednisolone (GCVP regiments) in the treatment of relapse and/or refractory non-hodgkin's lymphoma (NHL) in adults patients. Methods: 27 relapse and/or refractory non-hodgkin's lymphoma adult patients (Median:58 years old; range:47-72 years old) were diagnosed and previously treated with regimens such as R-CHOP(E), CHOP(E), MAED (Mitoxantrone, Cytarabine, Etoposide, Dexamethasone), FCM (Fludarabine, Cyclophosphamide, Mitoxantrone) based chemotherapy. There were 19 cases of diffuse large B cell lymphoma, 6 cases of follicular lymphoma, 1 case of NK/T cell type and 1 case of T cell NHL respectively. The GCVP chemotherapy (1000mg/m2 of gemcitabine, 750mg/m2 of cyclophosphamide, 25mg/m2 of vinblastine, intravenous drip on day 1 and day 8, prednisolone 50mg by intravenous drip on day 1 to day 5) were applied to these patients, safety and efficacy analyses were evaluated after two cycles. All patients provided written informed consent. Results: Among all the 27 patients who received GCVP chemotherapy, 3 patients achieved complete remission (CR) (11.11%), 15 patients achieved partial remission (PR) (55.56%), 9 patients with stable disease (SD) (33.33%), the overall response rate (ORR, CR+PR) was 66.67%. Patient's follow-up was continued after treatment, and the median duration of progression-free survival was 60 days. The main adverse events were bone marrow suppression, others were mild to moderate gastrointestinal reactions, a few had mild liver function damage, and it was reversible through hepatoprotection therapy. The most common grade ≥3 adverse events were leukopenia (33.33%, 9/27 cases), thrombocytopenia (40.74%, 11/27 cases), while anemia and gastrointestinal reaction were 11.11% (3/27 cases) and 3.70% (1/27 cases) respectively, no treatment-related death occurred. Discussion and conclusion: The overall outcomes for patients with lymphoma was improved, but there still part of NHL patients suffered form relapse or primary drug resistance, and the prognosis of these patients was poor. Gemcitabine combined with cyclophosphamide, vinblastine and hydrogenated prednisone has a good short-term efficacy in the treatment of relapse and/or refractory NHL. The main adverse reactions were hematologic toxicity and gastrointestinal reaction, mild liver function damage, and no treatment-related death was observed.