Liposomal Doxorubicin based Chemotherapy in the treatment of Relapsed Diffuse Large B-cell Lymphoma

Background: Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of non-Hodgkin's lymphoma (NHL) in adults. About 30-40% of NHL will suffer from relapse. Although anthracyclines are associated with a high response rate in aggressive NHL, these extended treatment regimens may result in cardiotoxicity and higher incidence of other toxic side effects. Pegylated liposomal doxorubicin (PLD) has been shown to allow for extended treatment with anthracycline in other tumor types, with a much lower cardiac toxicity risk.
The present study aimed to assess the response rate, survival and cardiac toxicity risk of patients with relapsed DLBCL treated with PLD.
Patients and Methods: Thirty patients with relapsed DLBCL were treated with liposomal encapsulated doxorubicin (30 mg/m²) in combination with cyclophosphamide, vincristine and predinisolone (PLD-COP) for 6 cycles in the period between January 2017 to December 2018,with median follow up 17 months (5-36 months). Survival analysis was done using Kaplan-Meier method to determine OS and PFS.
Results: Nine patients had complete response (30%), 15 patients (50%) had partial remission, 5 patients (16.67%) had progressive disease and 1 patient (3.33%) had stationary disease. The progression-free survival was 75.9% at 12 months and 57.3% at 24 months, while overall survival was 83.3% and 65.8% at 12 and 24 months. The median ejection fraction pre and post treatment remained the same denoting a trivial cardiac effect.
Conclusion: PLD offers another choice to patients seeking palliation from their lymphoma recurrence with a response rate of 80% that was well tolerated and had a minimal cardiac toxicity.