DHAP (chemotherapy)

DHAP is a chemotherapy regimen used primarily for the treatment of aggressive forms of non-Hodgkin lymphoma (NHL), including relapsed or refractory cases. The acronym DHAP stands for the drugs used in the regimen: Dexamethasone, High-dose Ara-C (cytarabine), and Platinum (cisplatin). This combination of drugs works synergistically to kill cancer cells, prevent their proliferation, and reduce the tumor burden in patients.

Components

• Dexamethasone: A corticosteroid used to reduce inflammation and the immune response. It also has antiemetic and antineoplastic properties.
• High-dose Ara-C (cytarabine): A chemotherapeutic agent that interferes with DNA synthesis, thus inhibiting the growth of cancer cells.
• Platinum (cisplatin): A platinum-containing compound that causes DNA crosslinking and apoptosis of cancer cells.

Indications

DHAP chemotherapy is indicated for patients with relapsed or refractory non-Hodgkin lymphoma. It is often considered when the disease does not respond to initial treatments or when there is a recurrence after initial remission. DHAP can also be used as a salvage therapy before a stem cell transplant.

Administration

The DHAP regimen is administered in cycles, typically every 3-4 weeks, depending on the patient's response and tolerance to the treatment. The administration involves hospitalization for the cisplatin and high-dose Ara-C components, due to the need for hydration and monitoring for potential side effects.

Side Effects

The combination of drugs in the DHAP regimen can lead to various side effects, including but not limited to:

• Nausea and vomiting
• Myelosuppression (reduction in bone marrow activity)
• Nephrotoxicity (kidney damage)
• Neurotoxicity (nerve damage)
• Infection risk due to immunosuppression

Patients undergoing DHAP chemotherapy are closely monitored for these side effects, and supportive care is provided to manage them.

Efficacy

Studies have shown that the DHAP regimen can be effective in inducing remission in patients with relapsed or refractory non-Hodgkin lymphoma. The success of the treatment varies depending on several factors, including the type of NHL, the stage of the disease, and the patient's overall health.

Conclusion

DHAP chemotherapy is a potent regimen for the treatment of aggressive non-Hodgkin lymphoma, particularly in cases where the disease has not responded to initial treatments. While it offers a chance for remission in difficult-to-treat cases, the potential for significant side effects requires careful patient selection and monitoring.