Dexametasona 40 mg/día d1 -4, 11-14
GCSF 5μ/Kg/día/SC d 5-12
Profilaxis del sistema nervioso central (SNC) (terapia intratecal)
Ciclo B
Rituximab 375 mg vía intravenosa (EV) d0
Metotrexate 1 gramo vía intravenosa (EV)/inf 24h d1
Leucovorina 12 horas post inf mtx, luego 12 mg/ c6h x 8 dosis. d2-3
Ara-C 12 g DT/3 gramos cada 12 horas 4 dosis d2-3
GCSF 5 μ/Kg/SC d5-12
Mantenimiento (POMP)
Puritenol 100mg VO OD x 21día
Oncovin 2 mg/día
Metotrexate 20-50mg/IM/semanal
Prednisona 40 mg vía oral x d1
8 ciclos alternos A y B
REFERENCIAS BIBLIOGRAFICAS
Dabaja BS, Phan J, Mawlawi O, Medeiros LJ, Etzel C, Liang FW, Podoloff D et al. Clinical implications of positron emission tomography-negative residual computed tomography masses after chemotherapy for diffuse large B-cell lymphoma. Leukemia & Lymphoma. 2013; 54 (12): 2631 – 8.
Fukuno K, Tsurumi H, Yamada T, Iida T, Takahashi T, Moriwaki H. Radioimmunotherapy with (90)Y-ibritumomab tiuxetan for a hemodialysis patient with relapsed follicular lymphoma. Leukemia & Lymphoma.2013; 54(12): 2731 -3.
George A, Tam CS, Seymour JF. High-risk diffuse large B-cell lymphoma: can we do better than rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone?. Leukemia & Lymphoma. 2013; 54(12): 2575 – 6.
Massimo F, Monica B, Luigi M, Stefano L, Armando L, Umberto V, Barbara P et al. Follicular Lymphoma International Prognostic Index 2: A New Prognostic Index for Follicular Lymphoma. Developed by the International Follicular Lymphoma Prognostic Factor Project. Journal of Clinical Oncology. 2009; 27 (27):455-4562.
Nagle SJ, Woo K, Schuster SJ, Nasta SD., Stadtmauer E, Mick R, Svoboda J. Outcomes of patients with relapsed/refractory diffuse large B-cell lymphoma with progression of lymphoma after autologous stem cell transplantation in the rituximab era. American Journal of Hematology. 2013; 88 (10): 890 – 4.
O’Neill BP, Decker, PA, Tieu C, Cerhan JR. The changing incidence of primary central nervous system lymphoma is driven primarily by the changing incidence in young and middle-aged men and differs from time trends in systemic diffuse large B-cell non-Hodgkin’s lymphoma. America Journal of Hematology. 2013; 88(12): 997 – 1000.
Rambaldi A, Boschini C, Gritti G, Delaini F, Oldani E et al. The lymphocyte to monocyte ratio improves the IPI-risk definition of diffuse large B-cell lymphoma when rituximab is added to chemotherapy. America Journal of Hematology. 2013; 88 (12): 1062 – 7.
Vijay A, Duan Q, Henning JW, Duggan P, Daly A, Shafey M, Bahlis NJ, Stewart DA. High dose salvage therapy with dose intensive cyclophosphamide, etoposide and cisplatin may increase transplant rates for relapsed/refractory aggressive non-Hodgkin lymphoma. Leukemia & Lymphoma. 2013; 54(12): 2620 – 6.
Zinzani PL, Pellegrini C, Broccoli A, Casadei B, Argnani L, Pileri S. Fludarabine-mitoxantrone-rituximab regimen in untreated intermediate/high-risk follicular non-Hodgkin’s lymphoma: Experience on 142 patients. American Journal of Hematology. 2013; 88 (11): E273 – 6.
Zeynalova S, Ziepert M, Scholz M, Schirm S, Zwick C, Pfreundschuh M, Loeffler M. Comparison and modelling of pegylated or unpegylated G-CSF schedules in CHOP-14 regimen of elderly patients with aggressive B-cell lymphoma. Annals of Hematology. 2013; 92 (12): 1641 – 5.