Second-line chemotherapy in human immunodeficiency virus-related non-Hodgkin's lymphoma: Evidence of activity of a combination of etoposide, mitoxantrone, and prednimustine in relapsed patients

Umberto Tirelli, Domenico Errante, Michele Spina, Roberta Gastaldi, Ezio Nigra, Anna Maria Nosari, Giacomo Magnani, Emanuela Vaccher

Research output: Contribution to journalArticle

Abstract

BACKGROUND. There is very little experience reported in the literature on the treatment of patients with relapsed or resistant human immunodeficiency virus-related non-Hodgkin's lymphoma (HIV-NHL). We performed a prospective study to evaluate the feasibility and activity of a second-line chemotherapy regimen consisting of etoposide, mitoxantrone, and prednimustine (VMP) in this setting. METHODS. Twenty-one patients were consecutively treated. Thirteen patients were resistant to primary chemotherapy and 8 patients had relapsed after their first complete remission (CR). Etoposide and prednimustine were both given orally at doses of 80 mg/m2 daily for 5 days, and mitoxantrone was given intravenously at a dose of 10 mg/m2 on Day I; the cycles were repeated every 3 weeks. RESULTS. Nineteen of 21 patients were evaluable for response. The median number of cycles administered was 2 (range, 1-5). A CR occurred in 5 of 19 patients (26%; exact 95% confidence interval; 9-51%). Four of these CRs were observed in the 7 evaluable relapsed patients. Of 45 cycles evaluable for toxicity, severe neutropenia (<500/μL) occurred in 19 (42%) cycles and severe thrombocytopema (<25,000/ μL) in 6 (13%) cycles. One toxic death occurred due to sepsis during neutropenia. The overall median survival was 2 months (range, <1-13 months); the median survival time for the 5 patients with CR (13 months; range, 6-13 months) was statistically significantly longer than that observed in patients without CR (2 months; range, <1-7 months). CONCLUSIONS. Although the overall prognosis of patients with resistant or relapsed HIV-NHL is very poor, palliative therapy with VMP can be effective and relatively safe in the latter group. Prolonged survival has been observed in some patients who had relapsed after initial chemotherapy.

Original languageEnglish
Pages (from-to)2127-2131
Number of pages5
JournalCancer
Volume77
Issue number10
Publication statusPublished - May 15 1996

Keywords

  • HIV
  • Non-Hodgkin's lymphoma
  • Second-line treatment
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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