Ifosfamide, gemcitabine, and vinorelbine: A new induction regimen for refractory and relapsed Hodgkin's lymphoma

Armando Santoro, Massimo Magagnoli, Michele Spina, Graziella Pinotti, Licia Siracusano, Mariagrazia Michieli, Andrea Nozza, Barbara Sarina, Emanuela Morenghi, Luca Castagna, Umberto Tirelli, Monica Balzarotti

Research output: Contribution to journalArticle

Abstract

Background and Objectives: Response to pre-transplant salvage chemotherapy remains the most important prognostic factor for outcome in refractory or relapsed Hodgkin's lymphoma. Results of a new induction regimen are reported in terms of response rates, toxicity, and stem cell mobilization. Design and Methods: Ninety-one patients with refractory or relapsed Hodgkin's lymphoma were treated prospectively with a salvage regimen consisting of ifosfamide 2000 mg/m2 on days 1 to 4, gemcitabine 800 mg/m2 on days 1 and 4, vinorelbine 20 mg/m2 on day 1, and prednisolone 100 mg on days 1 to 4 (IGEV). Results: Forty-nine patients (53.8%) achieved a complete remission and 25 (27.5%) a partial response for an overall response rate of 81.3%. In the multivariate analysis response to the last chemotherapy (p+ cell collection was achieved in 78 out of 79 (98.7%) mobilized patients. So far, no treatment-related death has been documented. Thirteen (4.2%) and 27 (8.6%) out of 313 evaluated cycles had to be delayed or reduced, respectively, mainly because of neutropenia and thrombocytopenia. No grade 4 non-hematologic toxicity was observed, except for one episode of mucositis. Interpretation and Conclusions: The high response rate, in particular the complete remission rate, the low toxicity profile, and the very high mobilizing potential of the IGEV regimen strongly suggest that patients with relapsed/refractory Hodgkin's lymphoma may benefit from the use of this salvage induction regimen.

Original languageEnglish
Pages (from-to)35-41
Number of pages7
JournalHaematologica
Volume92
Issue number1
DOIs
Publication statusPublished - Jan 2007

Keywords

  • CD34 cell mobilization
  • Complete remission
  • Hodgkin's lymphoma
  • Salvage chemotherapy

ASJC Scopus subject areas

  • Hematology

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