title: Mitoxantrone, etoposide, cisplatin and dexamethasone (MEPD) as salvage chemotherapy in resistant non-Hodgkin's lymphoma.
abstract: BACKGROUND
  An effective second-line treatment for intermediate and high grade non-Hodgkin's lymphoma is greatly needed since 30% of patients do not achieved complete remission (CR) and another 20% to 30% of the CRs will eventually relapse.
  
  
  METHODS
  A four-drug combination with Mitoxantrone, Etoposide, Cisplatin and Dexamethasone (MEPD) was devised for the treatment of patients with relapsing or refractory non-Hodgkin's lymphoma (NHL). So far 22 patients with intermediate or high grade NHL have entered the study. All patients were previously treated with doxorubicin based regimens.
  
  
  RESULTS
  Seven patients obtained a complete remission (CR), 3 a partial remission (PR), 4 a minor response (MR) and 8 were treatment failures (F). Thus, an overall response rate of 45% has been achieved. To date three of the complete responders have relapsed at 3, 6 and 15 months. Four patients are still in CR at +2, +4, +9 and +17 months, respectively. Patients with relapsing lymphoma responded better than those with primary refractory disease. Myelosuppression was the most frequent side effect, nevertheless there were no severe infections.
  
  
  CONCLUSIONS
  These preliminary results suggest the effectiveness of MEPD as salvage chemotherapy in resistant NHL and warrant further clinical studies.
authors.affiliation: Divisione di Ematologia, Ospedale Molinette, Torino, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Vitolo
authors.forename: L
authors.initials: L
authors.lastname: Orsucci
authors.forename: M
authors.initials: M
authors.lastname: Bertini
authors.forename: G
authors.initials: G
authors.lastname: Cavallero
authors.forename: A
authors.initials: A
authors.lastname: Gallamini
authors.forename: R
authors.initials: R
authors.lastname: Ghio
authors.forename: A
authors.initials: A
authors.lastname: Levis
authors.forename: D
authors.initials: D
authors.lastname: Rota-Scalabrini
authors.forename: L
authors.initials: L
authors.lastname: Resegotti
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004341:Drug Evaluation; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D012074:Remission Induction / Q000379:methods
chemical_list: D005047:Etoposide; D003907:Dexamethasone; D008942:Mitoxantrone; D002945:Cisplatin