Response Rate After Modified Regime DHAP and Toxicity with Refractory and Relapsed Disease in Lymphoma Patients

Reeta Kumari, Ghullam Haider, Nargis Abro, Amera Shah, Tooba Sarim, Khadijah Abid


Objective: To assess the response rate and toxicity of a modified regimen DHAP (dexamethasone, cytarabine, and cisplatin) and to compare treatment response and toxicity profile with disease status in patients with refractory and relapsed lymphoma who presented to a public hospital in Karachi, Pakistan.

Study Design: A cross sectional study.

Place and Duration of Study: The study was conducted at the Oncology Department of Jinnah Postgraduate Medical College, Karachi, Pakistan, from December 2021 to October 2022.

Materials and Methods: Modified DHAP was used to treat all individuals with lymphoma who had refractory disease or had relapse. The modified DHAP treatment includes intravenous infusions of dexamethasone 40 mg every 15 minutes on days 1 through 4, cisplatin 25 mg every 3 hours on days 1 through 4, and cytarabine 2×0.5 g/m2 every hour on days 1 through 4. Cycles were repeated every three weeks. Following each cycle, toxicity was evaluated using WHO criteria. A CT scan and a physical examination were used to assess the therapy response.

Results: The median age was 41, ranging from 20 to 74 years. Most of the patients were males (73.9%). Of 92 patients, 32 had refractory disease, and 60 had relapse. Twenty-nine patients had a complete response, 45 patients had a partial response, and the overall response rate of modified DHAP was 80.4%. The most frequent toxicity of modified DHAP was pancytopenia (46.7%), followed by febrile neutropenia (14.1%), respectively. Mortality occurred in 4 patients (13%). Febrile neutropenia was reported more in non-Hodgkin’s lymphoma patients than in Hodgkin’s lymphoma patients, with a p-value=0.014.

Conclusion: Modified DHAP has a better overall response rate and manageable toxicity profile in patients with refractory or relapsed lymphoma.

Keywords: Lymphoma, Modified DHAP, Relapse Lymphoma, Refractory Disease, Toxicity.

How to cite this: Kumari R, Haider G, Abro N, Shah A, Sarim T, Abid K. Response Rate After Modified Regime DHAP and Toxicity with Refractory and Relapsed Disease in Lymphoma Patients. Life and Science. 2023; 4(4):   . doi:

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