Abstract
After therapy with adriamycin-containing regimens, relapsed or refractory non-Hodgkin's lymphomas (NHL) have a very poor prognosis. Although high dose chemotherapies are widely employed, their related costs and the controversial results achieved justify the development of new second-line conventional therapies. Forty-three patients with relapsed or refractory NHL were consequently treated with an outpatient polychemotherapy schedule including ifos-famide, mitoxantrone and etoposide on day 1, and vindesine, cisplatinum and cytosine ara-binoside on day 15. The courses were repeated on day 29. All of the patients were pretreated with at least one chemotherapy regimen. Twenty-two patients had diffuse large cell lymphoma, 8 had bone marrow involvement, and 17 altered baseline lactate dehydrogenase (LDH) values. After a median number of 4 cycles (range 2-8), we registered 20 complete (46% and 4 partial remissions, for an overall remission rate of 56% (95% confidence interval: 40-71% All of the responses occurred in patients who had achieved at least partial remission during first-line therapy. Four patients are long term responders after 31, 39, 49 and 52 months, and are possibly cured. Univariate analysis of prognostic factors showed that baseline LDH values and response to front-line therapy significantly affected both time to disease progression and survival, whereas the number of previous treatments given, significantly affected only the time to progression. Therapy was administered in an out-patient setting and no life-threatening toxicity was observed. Side effects consisted of nausea/vomiting, alopecia and reversible myelosuppression. The results suggest that different treatment strategies for relapsed and refractory patients should be considered on the basis of prognostic factors. The proposed schedule may be potentially curative in a subgroup of relapsed patients at better risk; poor risk refractory patients should be considered for investigational trials involving high-dose chemotherapy.
| Original language | English |
|---|---|
| Pages (from-to) | 121-128 |
| Number of pages | 8 |
| Journal | Leukemia and Lymphoma |
| Volume | 14 |
| Issue number | 1-2 |
| DOIs | |
| Publication status | Published - 1994 |
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Keywords
- Non-Hodgkin's lymphoma
- Salvage chemotherapy
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research
Cite this
Results of a salvage regimen in refractory or relapsed non-hodgkin's lymphoma. / Buzzoni, Roberto; Colleoni, Marco; Nelli, Patrizia; Nole, Franco; Bajetta, Emilio.
In: Leukemia and Lymphoma, Vol. 14, No. 1-2, 1994, p. 121-128.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Results of a salvage regimen in refractory or relapsed non-hodgkin's lymphoma
AU - Buzzoni, Roberto
AU - Colleoni, Marco
AU - Nelli, Patrizia
AU - Nole, Franco
AU - Bajetta, Emilio
PY - 1994
Y1 - 1994
N2 - After therapy with adriamycin-containing regimens, relapsed or refractory non-Hodgkin's lymphomas (NHL) have a very poor prognosis. Although high dose chemotherapies are widely employed, their related costs and the controversial results achieved justify the development of new second-line conventional therapies. Forty-three patients with relapsed or refractory NHL were consequently treated with an outpatient polychemotherapy schedule including ifos-famide, mitoxantrone and etoposide on day 1, and vindesine, cisplatinum and cytosine ara-binoside on day 15. The courses were repeated on day 29. All of the patients were pretreated with at least one chemotherapy regimen. Twenty-two patients had diffuse large cell lymphoma, 8 had bone marrow involvement, and 17 altered baseline lactate dehydrogenase (LDH) values. After a median number of 4 cycles (range 2-8), we registered 20 complete (46% and 4 partial remissions, for an overall remission rate of 56% (95% confidence interval: 40-71% All of the responses occurred in patients who had achieved at least partial remission during first-line therapy. Four patients are long term responders after 31, 39, 49 and 52 months, and are possibly cured. Univariate analysis of prognostic factors showed that baseline LDH values and response to front-line therapy significantly affected both time to disease progression and survival, whereas the number of previous treatments given, significantly affected only the time to progression. Therapy was administered in an out-patient setting and no life-threatening toxicity was observed. Side effects consisted of nausea/vomiting, alopecia and reversible myelosuppression. The results suggest that different treatment strategies for relapsed and refractory patients should be considered on the basis of prognostic factors. The proposed schedule may be potentially curative in a subgroup of relapsed patients at better risk; poor risk refractory patients should be considered for investigational trials involving high-dose chemotherapy.
AB - After therapy with adriamycin-containing regimens, relapsed or refractory non-Hodgkin's lymphomas (NHL) have a very poor prognosis. Although high dose chemotherapies are widely employed, their related costs and the controversial results achieved justify the development of new second-line conventional therapies. Forty-three patients with relapsed or refractory NHL were consequently treated with an outpatient polychemotherapy schedule including ifos-famide, mitoxantrone and etoposide on day 1, and vindesine, cisplatinum and cytosine ara-binoside on day 15. The courses were repeated on day 29. All of the patients were pretreated with at least one chemotherapy regimen. Twenty-two patients had diffuse large cell lymphoma, 8 had bone marrow involvement, and 17 altered baseline lactate dehydrogenase (LDH) values. After a median number of 4 cycles (range 2-8), we registered 20 complete (46% and 4 partial remissions, for an overall remission rate of 56% (95% confidence interval: 40-71% All of the responses occurred in patients who had achieved at least partial remission during first-line therapy. Four patients are long term responders after 31, 39, 49 and 52 months, and are possibly cured. Univariate analysis of prognostic factors showed that baseline LDH values and response to front-line therapy significantly affected both time to disease progression and survival, whereas the number of previous treatments given, significantly affected only the time to progression. Therapy was administered in an out-patient setting and no life-threatening toxicity was observed. Side effects consisted of nausea/vomiting, alopecia and reversible myelosuppression. The results suggest that different treatment strategies for relapsed and refractory patients should be considered on the basis of prognostic factors. The proposed schedule may be potentially curative in a subgroup of relapsed patients at better risk; poor risk refractory patients should be considered for investigational trials involving high-dose chemotherapy.
KW - Non-Hodgkin's lymphoma
KW - Salvage chemotherapy
UR - http://www.scopus.com/inward/record.url?scp=0028305999&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028305999&partnerID=8YFLogxK
U2 - 10.3109/10428199409049657
DO - 10.3109/10428199409049657
M3 - Article
VL - 14
SP - 121
EP - 128
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 1-2
ER -