Clinical outcomes of advanced-stage cutaneous lymphoma under low-dose gemcitabine treatment: real-life data from the German cutaneous lymphoma network
<b><i>Background:</i></b> Gemcitabine is an effective single-agent chemotherapy used in advanced stages of cutaneous T-cell lymphoma (CTCL). However, gemcitabine used in the current standard regimen is frequently associated with adverse events (AE), such as an increased risk...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2022
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| In: |
Dermatology
Year: 2022, Volume: 238, Issue: 3, Pages: 498-506 |
| ISSN: | 1421-9832 |
| DOI: | 10.1159/000517830 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000517830 Verlag, lizenzpflichtig, Volltext: https://www.karger.com/Article/FullText/517830 
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| Author Notes: | Christoph Blazejak, Rene Stranzenbach, Janika Gosman, Thilo Gambichler, Ulrike Wehkamp, Sarja Stendel, Claus-Detlev Klemke, Marion Wobser, Joanna Olk, Jan P. Nicolay, Maria Weyermann, Rudolf Stadler, Chalid Assaf |
| Summary: | <b><i>Background:</i></b> Gemcitabine is an effective single-agent chemotherapy used in advanced stages of cutaneous T-cell lymphoma (CTCL). However, gemcitabine used in the current standard regimen is frequently associated with adverse events (AE), such as an increased risk for myelosuppression and severe infections. <b><i>Objectives:</i></b> We investigated in this retrospective study the effect of low-dose gemcitabine in pretreated advanced-stage CTCL and in blastic plasmacytoid dendritic cell neoplasia (BPDCN) regarding overall response (OR), progression-free survival (PFS), and AE. <b><i>Material and Methods:</i></b> A retrospective, multicenter study was conducted on 64 CTCL and BPDCN patients treated with gemcitabine in average absolute dosage of 1,800 mg/m<sup>2</sup> per cycle, which is 50% lower compared to standard dosage of 3,600 mg/m<sup>2</sup> per cycle (1,200 mg/m<sup>2</sup> day 1, 8, 15). Evaluation of response to therapy and AE was done 4-6 weeks after the sixth cycle. <b><i>Results:</i></b> OR was 62% with 11% demonstrating a complete response. The median time of PFS was 12 months and median time to next treatment was 7 months. Only 3/63 patients showed serious side effects, e.g., port infection or acute renal failure. Almost 73% of the patients experienced minor to moderate side effects (CTCAE grade 0-2). Fatigue (27.2%), fever (22.7%), and mild blood count alteration (18.2%) were the most common AE. <b><i>Conclusions:</i></b> This retrospective analysis supports the use of low-dose gemcitabine therapy in CTCL, demonstrating with 62% OR and PFS of 12 months an almost identical response rate and survival as compared to the standard dose therapy reported in previous studies but with a significantly improved safety profile and tolerability. |
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| Item Description: | Gesehen am 16.12.2022 |
| Physical Description: | Online Resource |
| ISSN: | 1421-9832 |
| DOI: | 10.1159/000517830 |