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

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gemcitabine
Ifosfamide
Hodgkin Disease
Hematopoietic Stem Cell Mobilization
Drug Therapy
Mucositis
Prednisolone
Neutropenia
Thrombocytopenia
Multivariate Analysis
Transplants
vinorelbine

Keywords

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

ASJC Scopus subject areas

  • Hematology

Cite this

@article{64a5c2321e844abebe6dabd7564f086a,
title = "Ifosfamide, gemcitabine, and vinorelbine: A new induction regimen for refractory and relapsed Hodgkin's lymphoma",
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.",
keywords = "CD34 cell mobilization, Complete remission, Hodgkin's lymphoma, Salvage chemotherapy",
author = "Armando Santoro and Massimo Magagnoli and Michele Spina and Graziella Pinotti and Licia Siracusano and Mariagrazia Michieli and Andrea Nozza and Barbara Sarina and Emanuela Morenghi and Luca Castagna and Umberto Tirelli and Monica Balzarotti",
year = "2007",
month = "1",
doi = "10.3324/haematol.10661",
language = "English",
volume = "92",
pages = "35--41",
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TY - JOUR

T1 - Ifosfamide, gemcitabine, and vinorelbine

T2 - A new induction regimen for refractory and relapsed Hodgkin's lymphoma

AU - Santoro, Armando

AU - Magagnoli, Massimo

AU - Spina, Michele

AU - Pinotti, Graziella

AU - Siracusano, Licia

AU - Michieli, Mariagrazia

AU - Nozza, Andrea

AU - Sarina, Barbara

AU - Morenghi, Emanuela

AU - Castagna, Luca

AU - Tirelli, Umberto

AU - Balzarotti, Monica

PY - 2007/1

Y1 - 2007/1

N2 - 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.

AB - 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.

KW - CD34 cell mobilization

KW - Complete remission

KW - Hodgkin's lymphoma

KW - Salvage chemotherapy

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DO - 10.3324/haematol.10661

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JF - Haematologica

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