Mitoxantrone, etoposide, cisplatin and dexamethasone (MEPD) as salvage chemotherapy in resistant non-Hodgkin's lymphoma.
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.
Vitolo
U
U
Divisione di Ematologia, Ospedale Molinette, Torino, Italy.
Orsucci
L
L
Bertini
M
M
Cavallero
G
G
Gallamini
A
A
Ghio
R
R
Levis
A
A
Rota-Scalabrini
D
D
Resegotti
L
L
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
D005047:Etoposide; D003907:Dexamethasone; D008942:Mitoxantrone; D002945:Cisplatin